Robert Braun, Anne Loeber, Malene Vinther Christensen, Joshua Cohen, Elisabeth Frankus, Erich Griessler, Helmut Hönigmayer and Johannes Starkbaum
This study aims to discuss science governance in Europe and the network of associated nonprofit institutions. The authors posit that this network, which comprises both (partial…
Abstract
Purpose
This study aims to discuss science governance in Europe and the network of associated nonprofit institutions. The authors posit that this network, which comprises both (partial) learning organizations and non-learning organizations, has been observed to postpone taking up “responsibility” as an issue in science governance and funding decisions.
Design/methodology/approach
This paper discusses the challenge of learning and policy implementation within the European science governance system. By exploring how learning on responsible innovation (RI) in this governance system can be provoked, it addresses the question how Senge’s insights in organizational learning can clarify discourses on and practices of RI and responsibility in research. This study explores the potential of a new organizational form, that of Social Labs, to support learning on Responsible Research and Innovation (RRI) in standing governance organizations.
Findings
This study concludes that Social Labs are a suitable format for enacting the five disciplines as identified by Senge, and a Social Lab may turn into a learning organization, be it a temporary one. Responsibility in research and innovation is conducive for learning in the setting of a Social Lab, and Social Labs act as intermediary organizations, which not merely pass on information among actors but also actively give substantive shape to what they convey from a practice-informed, normative orientation.
Research limitations/implications
This empirical work on RRI-oriented Social Labs therefore suggests that Social Lab–oriented temporary, intermediary learning organizations present a promising form for implementing complex normative policies in a networked, nonhierarchical governance setting.
Practical implications
Based on this research funding and governance organizations in research, policy-makers in other domains may take up and create such intermediary organizations to aid learning in (science) governance.
Social implications
This research suggests that RRI-oriented Social Labs present a promising form for implementing complex normative policies, thus integrate learning on and by responsible practices in various governance settings.
Originality/value
European science governance is characterized by a network of partial Learning Organization (LOs) and Non-Learning Organization (nLOs) who postpone decision-making on topics around “responsibility” and “solving societal challenges” or delegate authority to reviewers and individual actors, filtering possibilities for collaborative transformation toward RRI. social lab (SLs) are spaces that can address social problems or social challenges in an open, action-oriented and creative manner. As such, they may function as temporary, intermediary LOs bringing together diverse actors from a specific context to work on and learn about issues of science and society where standing organizations avoid doing so. Taken together, SLs may offer temporary organizational structures and spaces to move beyond top-down exercise of power or lack of real change to more open, deliberative and creative forms of sociopolitical coordination between multiple actors cutting across realms of state, practitioners of research and innovation and civil society. By taking the role of temporary LOs, they may support existing research and innovation organizations and research governance to become more flexible and adaptive.
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In this chapter, we address the question of what health economic models represent. Are they realistic? And, does model realism matter? Or, is model usefulness in terms of…
Abstract
In this chapter, we address the question of what health economic models represent. Are they realistic? And, does model realism matter? Or, is model usefulness in terms of informing pricing, reimbursement, and prescribing decisions all policymakers care about? The usefulness of models is circumscribed given that: (1) market failure is inherent in healthcare and (2) models oversimplify the preference structure underlying choices. We suggest, however, that models which employ the ceteris paribus clause can be useful in order to isolate factors that play a role in healthcare decision-making and ultimately characterize agents’ multiattribute utility functions through discrete choice experiments. As a result, policymakers gain important knowledge about decision criteria in the healthcare system.
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John F.P. Bridges, Joshua P. Cohen, Peter G. Grist and Axel C. Mühlbacher
Purpose – Although the US has lagged behind international developments in health technology assessment (HTA), renewed interest in HTA in the US has been fueled by the…
Abstract
Purpose – Although the US has lagged behind international developments in health technology assessment (HTA), renewed interest in HTA in the US has been fueled by the appropriation of $1.1 billion comparative effectiveness research (CER) in 2009 and the debate over health care reform.
Approach – To inform CER practices in the US, we present case studies of HTA from England/Wales and Germany: contrasting methods; relevance to the US; and impact on innovation.
Findings – The National Institute of Health and Clinical Excellence (NICE) was established in 1999 to inform trusts within the National Health Service of England and Wales. It uses cost-effectiveness analysis to guide the allocation resource across preventative and curative interventions. In Germany, the Institut für Qualität und Wirtschaftlichkeit im Gesundheitswesen (IQWiG) was established in 2004 to inform reimbursement and pricing policies for the statutory sickness funds set by the Gemeinsamer Bundesausschuss (G-BA). IQWiG evaluates competing technologies within specific therapeutic areas, placing more weight on clinical evidence and the relative efficiency of competing therapies.
Practical implications – Although having deep political and cultural antecedents, differences between NICE and IQWiG can be explained by perspective: the former guiding resource allocation across an entire system (macro-evaluation), the latter focusing on efficiency within the bounds of a particular therapeutic area (micro-evaluation). Given the decentralized nature of the US health care system, and the relative powers of different medical specialties, the IQWiG model presents a more suitable case study to guided CER efforts in the US.
The purpose of this paper is to provide commentary on the state of affairs regarding implementation of Dutch health insurance reform, focusing on whether such reform is conducive…
Abstract
Purpose
The purpose of this paper is to provide commentary on the state of affairs regarding implementation of Dutch health insurance reform, focusing on whether such reform is conducive to pharmaceutical innovation.
Design/methodology/approach
The general characteristics of the Dutch healthcare system is outlined, together with a brief synopsis of the 2006 health insurance reform initiative. This is followed by a description of the four market intervention mechanisms and their implications for pharmaceutical innovation. Finally, these implications and the potential for policy transfer to other European countries are discussed.
Findings
The new Dutch health insurance system represents a novel approach that closely follows Enthoven's managed competition model. Certain features of the new system are conducive to pharmaceutical innovation. These positive features include more flexibility on the part of private insurers to deviate from the national formulary, speedier reimbursement appraisals, and more earmarked funding for certain highly innovative pharmaceutical products. Other features, however, appear detrimental to drug innovation. These include direct price controls, reference pricing, and the still highly centralized nature of decision making with respect to drug reimbursement. On the whole, one could say that, despite many challenges, Dutch health insurance reform is a step in the right direction that may prove to be a boon to biopharmaceutical innovation if further steps are taken to remove obstacles.
Research limitations/implications
It is premature to draw firm conclusions on whether Dutch health insurance reform is conducive to pharmaceutical innovation. The new system is at an early stage in its evolution. Further, one should be cautious about the extent to which lessons can be drawn from the new Dutch system for other European countries, given the limited size of the Dutch biopharmaceutical industry relative to some of its European neighbors.
Originality/value
While much is known about how changes in the drug regulatory framework impact pharmaceutical innovation, very little is known about how changes in health care insurance impact pharmaceutical innovation. This paper aims to fill that void by examining the impact of the new Dutch health insurance system on drug innovation.
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I have taken this essay on Mark Bevirʼs latest book as an opportunity to critically reflect on diverse perspectives within radical democratic theory. My first aim here is to…
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I have taken this essay on Mark Bevirʼs latest book as an opportunity to critically reflect on diverse perspectives within radical democratic theory. My first aim here is to simply describe Bevirʼs historical and interpretive account of governance in general, interdisciplinary terms. My second aim is the more specific, disciplinary one of comparing the scholarly contributions of Mark Bevirʼs Democratic Governance with those of Chantal Mouffeʼs The Democratic Paradox and Archon Fungʼs Empowered Participation, two influential publications in contemporary political theory. I conclude by discussing the relative powers and limits of Bevirʼs genealogical, Mouffeʼs deconstructive, and Fungʼs procedural approaches to radical democratic theory.
The purpose of this paper is to analyze the reception and impact of Jürgen Habermas’s global academic best seller in the USA between 1974 and 2018. It specifically addresses the…
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Purpose
The purpose of this paper is to analyze the reception and impact of Jürgen Habermas’s global academic best seller in the USA between 1974 and 2018. It specifically addresses the consequences of the long delay in the publication of the English translation of Habermas’s 1962 public sphere concept until 1989 in the context of Habermas’s paradigm shift from the Kantian ideal of a participatory democracy to a systems-theoretical interpretation of deliberative democracy, which informs Between Facts and Norms (1992/1996).
Design/methodology/approach
This paper can be classified as a “conceptual paper” that draws on empirical research, namely, Adrian Rauchfleisch’s (2017) bibliometric co-citation analysis of two decades of public sphere research, which features a multi-dimensional scaling of these research communities based on the distance matrix of the co-citation network.
Findings
As the 22,000 scholarly citations for structural transformation as of April 2018 already indicate, this paper confirms in detail that Habermas’s original public sphere concept attracts significantly more academic interest on an interdisciplinary basis than Between Facts and Norms, which no longer pursues a critical theory of contemporary democracy. Instead, this shift toward a uniquely sophisticated theory construction in the realm of normativity produces a work in Rechtstheorie (Thomas McCarthy) that is by definition removed from political practice. The paper demonstrates that only the criteria developed in structural transformation can be applied to the analysis of constitutional crises in the USA.
Originality/value
This paper was researched and written solely by the author. All sources are clearly identified.