Federalism and Health Care Cost Containment in Comparative Perspective’, Publius: The
Bibliographic record
Abstract
Despite widespread agreement over the connection between federalism and social expenditures during times of welfare state expansion, disagreement exists concerning federalism’s role in the retrenchment era. Existing approaches fail to recognize institutional variation among federal states. Analysis of Britain, Germany, and Canada suggests that federalism may promote or hinder health care retrenchment depending upon how it structures the relationship between regional and national governments. Power-sharing federalism hinders health care reform by increasing the institutional obstacles to unpopular cutbacks. Power-separating federalism facil-itates reform by creating opportunities for blame avoidance without substantially increasing the number of veto players. These findings challenge traditional linear or dichotomous models of federalism, suggesting the need for an approach that captures how particular types of federalism affect retrenchment politics. Comparative social policy literature generally relies on a shallow understanding of the role of federalism in welfare politics. Federalism is largely understood as one of a number of institutional ‘‘veto points’ ’ like bicameralism or presidentialism that serves as a brake on welfare state expansion. By fragmenting political authority and increasing the number of decision makers involved in policymaking, federalism expands the opportunities for opponents of the welfare state to block major legislation. Empirical evidence consistently confirms the role of federalism in constraining social expenditures and welfare state programs (Huber and Stephens
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.004 | 0.006 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.003 | 0.003 |
| Science and technology studies | 0.002 | 0.012 |
| Scholarly communication | 0.006 | 0.006 |
| Open science | 0.001 | 0.002 |
| Research integrity | 0.002 | 0.002 |
| Insufficient payload (model declined to judge) | 0.010 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".