Nissim Cohen

Field research in conflict environments: Methodological challenges and snowball sampling

Conducting research in conflict environments is a challenge, given their complexity and common attitudes of distrust and suspicion. Yet, conflict and methodology are usually analyzed as separate fields of interest. Methodological aspects of field work in conflict environments have not been systematically analyzed. This article addresses the central methodological problems of research conducted in conflict environments. We suggest the use of the snowball sampling method (hereafter, SSM) as an answer to these challenges. The effectiveness of this method has been recognized as significant in a variety of cases, mainly regarding marginalized populations. We claim that in conflict environments, the entire population is marginalized to some degree, making it ‘hidden’ from and ‘hard to reach’ for the outsider researcher. The marginalization explains why it is difficult to locate, access and enlist the cooperation of the research populations, which in a non-conflict context would not have been difficult to do. SSM directly addresses the fears and mistrust common to the conflict environment and increases the likelihood of trusting the researcher by introduction through a trusted social network. We demonstrate how careful use of SSM as a ‘second best’ but still valuable methodology can help generate cooperation. Therefore, the evaluation of SSM, its advantages and limitations in implementation in conflict environments can be an important contribution to the methodological training of researchers. In addition to its effectiveness under conditions of conflict, SSM may, in some cases, actually make the difference between research conducted under constrained conditions and research not conducted at all. Together with our experiences in the field, we supply several insights and recommendations for optimizing the use of SSM in a conflict environment.

Trust, Participation, and Performance in Public Administration: An Empirical Examination of Health Services in Israel

This paper suggests a framework for measuring trust in health care at the institutional level and for explaining the impact of structural variables on trust. The empirical study was conducted in Israel using a national survey. Trust in health care is found to be positively related with performance and satisfaction much more than with participation in decision-making processes and other structural variables such as accessibility, equality, and autonomy. Participation is positively related with performance. The paper also provides an explanation based on political culture for the weak relations between participation in decision-making and trust in health-care organizations.

Public attitudes towards the welfare state and public policy: the Israeli experience

This article provides data and insights into Israeli public opinion about the welfare state and social policy. The study included 940 respondents who reported their attitudes towards various issues related to the welfare state. The study was conducted in spring 2008 prior to the current economic crisis. The findings show that, to a large extent, the Israeli public justifies state intervention in the supply of public services, supports public investment in services related to the welfare state, and recognizes the obligation to support those in need. As for various policy areas, the Israeli public regards education as a top priority, believing that investment in public education is likely to lead to achievements in other areas such as security and health. However, when asked about their willingness to pay more taxes for services related to the welfare state, respondents tended to be less enthusiastic. The research points to a significant gap between the social and economic policies in the past decade and the attitudes of large parts of Israeli society towards the welfare state. We provide possible explanations for that gap.

Trust, Participation and Performance

Abstract This article studies the possible impact of citizen and worker participation in decision making (PDM) in the Israeli National Insurance Institute (INI) on the perceived performance of this organization, and trust in it. Such an impact is expected according to the rationales suggested by the New Public Management (NPM) approach. The findings show that customers and employees of the INI correlate trust with performance and outcomes much more than with participation in decision-making processes. We suggest a potential explanation for the weak relationship between PDM and trust based on the idea of alternative politics and segments of the political culture.

Speed or Greed? High Wages and Corruption Among Public Servants

Scholars maintain that higher wages for public servants would make the public sector more efficient and reduce the abuse of power. This article challenges this idea and suggests that higher wages may actually increase public corruption. We argue that increasing pecuniary incentives for public service might lead public employees to advance their own self-interests and encourage justifications for accepting bribes. We test our theory empirically using 18,800 observations from 58 countries taken from the sixth wave of the World Values Survey. The findings confirm our theory and suggest a positive association between public servants’ wages and the toleration of corruption.

Privatization Through Centralization in the Israeli Health Care System: The Case of the National Health Insurance Law and its Amendments

This article addresses a policy paradox that characterizes many health care systems and the Israeli system in particular, that is, the existence of two parallel yet seemingly contradictory policy trends: reducing public financing for health care services while increasing governmental involvement in health-system management. The authors characterize this process as privatization through centralization; that is, to control welfare-state expenses and be able to reduce them, the government must first control the funding and management of welfare-state mechanisms and organizations. They develop a theoretical rationale for explaining this policy paradox and demonstrate it through analyzing the legislative changes that followed the legislation of the National Health Insurance Law in Israel.

The Incentives of Street-Level Bureaucrats and Inequality in Tax Assessments

How do the incentives offered to street-level bureaucrats influence the value of equality in society? To investigate this question, we consider as a case study the incentives offered to tax officials in Israel that encourage them to intimidate ordinary citizens during tax audits and use uncertainty and asymmetry of information for their own benefit. We demonstrate that such practices lead to social injustice and an increase in gaps between income groups. We then offer suggestions at the individual and organizational level for ameliorating these problems.

Bargaining and informal interactions in the national budget: a game theory analysis of the Israeli case

This article suggests a game theory analysis of the interaction between Israeli politicians and bureaucrats regarding the national budget process since the 1980s. During the 1970s and 1980s new structural conditions created new formal and informal rules that weakened Israeli politicians’ bargaining position vis-à-vis the Ministry of Finance (MOF). The 1985 Israeli Economic Stabilization Plan not only changed the formal political institutions, but also created new informal institutions. Under the new circumstances, Israeli politicians can rarely challenge the MOF in the political bargaining process. Given that the MOF officials are aware of Israel’s internal processes and public opinion, attempts by Israeli politicians to create the impression that they are willing to challenge the MOF officials are unlikely. We demonstrate that this situation may ultimately lead to a sub-optimal equilibrium for Israel’s social welfare because the balance of power between the players favors one dominant side – the MOF officials. Points for practitioners This article provides insights into how institutional change and various formal and informal political strategies are played out in budgetary decision-making. When structural conditions create new formal and informal rules that weaken politicians’ bargaining position vis-à-vis the Ministry of Finance, politicians may find it very hard to challenge the Ministry of Finance officials. The results may include the creation of a significant gap between public opinion and the socioeconomic policy in practice. The key for preventing such scenarios is making sure, via strong institutions, that the balance of power between the players will not favor one dominant side.

How Culture Affects Street-Level Bureaucrats’ Bending the Rules in the Context of Informal Payments for Health Care: The Israeli Case

What is the role of culture in street-level bureaucrats’ bending the rules and accepting informal payments for health care? The literature on street-level bureaucrats stresses the importance of both individual and organizational factors in understanding how they use their discretion but usually neglects the importance of the culture in determining how far they are willing to go in exercising this discretion. Using data from 102 in-depth interviews with doctors and nurses in Israel, and by linking the literature about street-level bureaucrats to that of the research on informal payments for health care, we demonstrate that the culture plays a key role in decisions about accepting such payments. According to our findings, such payments are a phenomenon rooted in the culture and range from the extreme case of bribery to the fuzzier area of making exceptions for favored and sympathetic clients.

Policy entrepreneurship and policy networks in healthcare systems – the case of Israel’s pediatric dentistry reform

BackgroundCan the entry of a policy entrepreneur challenge the equilibrium of a policy network and promote changes that might clash with the goals of powerful civil-servants and/or interest groups and, if so, why and how? Our goal is to examine two sides of the same coin: how does an in-depth analysis of Israel’s dental care reform enrich our understanding of policy networks and policy entrepreneurship? Second, how does the literature on policy networks and policy entrepreneurship help us understand this reform? Based on a theoretical framework that appears in the literature of policy entrepreneurship and policy networks, we analyze the motivations, goals and strategies of the main actors involved in the process of reforming pediatric dental care in Israel. We demonstrate how a policy entrepreneur navigated within a policy network and managed to promote a reform that, until his appearance, no one else in that network had succeeded in enacting.MethodsOur goals are advanced through a case study of a reform in pediatric dentistry implemented in Israel in 2010. It rests on textual analyses of the literature, reports, committee minutes, parliamentary proceedings, print and online media, and updates in relevant legislation and case law between 2009 and 2015. In addition, the case study draws on the insights of one of the authors (TH), who played a role in the reform process.ResultsHistorical circumstances and the Israeli public’s longstanding lack of interest in changing the existing model as well as interest groups that preferred the dominance of the private sector in the dental healthcare system kept that area out of the services supplied, universally, under the National Health Insurance Law. This situation changed significantly following the publication in 2007 of a policy analysis that contributed to shifts in the motivations and balance of power within the policy network, which in turn prepared the ground for a policy change. In this environment a determined policy entrepreneur, who identified a window of opportunity, took the lead and instituted an innovative and far-reaching reform.ConclusionsA policy entrepreneur can leverage external factors as well as the previous activities of a policy network that has already matured to create a policy change. Such entrepreneurial activity includes maneuvering around opponents and overcoming resistance from various stakeholders.