The Regulatory State: How Democratic?

Abstract

The principle of subsidiarity was formally introduced as a principle of intention in the 1991 Treaty of Maastricht that recognized the devolution of competence, i.e., 'decision-making to be performed at the lowest possible effective administrative level' in the European multi-level system of governance. The rhetoric deployed on behalf of the principle of subsidiarity elaborated it and strongly suggested that it was, as it were, a principle of 'nearness' to the people, implying a more bottom-up form of governance and a more democratic mean of voicing opinions. But in what kind of framework should 'nearness' take place? Should it take place within the framework of the devolution of competence to elected national assemblies and the emancipation of constituencies? Or should it be applied within the framework of the regulatory stat that makes use of national and international arm's-length agencies and other governmental bodies in its governance approach? The paper gives answers to these questions, and examines how different approaches to the concept of democracy transform governance structures.

Assessment of new public management in health care: the French case

“…Greater reliance on market-based mechanisms, reduced state-ownership, and rising private financing [ 119 ] imply more – not less – government regulations (e.g., regarding the pricing of health services, establishment of care providers) to manage hospital competition, as in the Anglo-Saxon model [ 120 ]. This theory of an active regulatory welfare state [ 5 , 121 ], which is “ not based on the extension of the public sphere, but on the reduction of the autonomy of non-state actors ”, relies on standards (DRGs, GPs pay-for-performance schemes) and regulations of new entrants, for instance private operators, to govern ‘at a distance’ [ 122 , 123 ]. Despite these advances, major public issues remain unresolved.…”