Steven J. Balla

Interstate Professional Associations and the Diffusion of Policy Innovations

Although scholars have found that policy innovations diffuse across states in a systematic manner, they generally have not examined the role that individuals and institutions play in promoting diffusion. I posit that interstate professional associations provide institutional foundations for the development and dissemination of innovations by state officials with jurisdiction over particular policy areas. I test this hypothesis by examining the determinants of state adoption of the Health Maintenance Organization (HMO) Model Act, a comprehensive set of regulations developed by the National Association of Insurance Commissioners (NAIC). My central finding is that states whose insurance commissioner participated in the NAIC’s Accident and Health Insurance Committee, which has jurisdiction over HMO regulation, were more likely than other states to adopt the Model Act. This result provides evidence that associations can affect policy diffusion. It also sharpens the conventional wisdom by highlighting a specific institutional arrangement—a committee system—through which participation in associations can facilitate the adoption of innovations.

Administrative Procedures and Political Control of the Bureaucracy

administrative procedure-the notice and comment process-in the context of Medicare physician payment reform, a fundamental restructuring of the way in which the Medicare program pays for physician services. I find, contrary to the deck-stacking thesis, that the Health Care Financing Administration (HCFA) was more responsive to physicians expecting reductions in fees than to the intended beneficiaries of the new payment system. Although these results do not necessarily imply that Congress exerted little influence over HCFA decision making, they suggest that certain administrative procedures do not operate as instruments of political control. D elegation of policymaking authority from elected officials to unelected bureaucrats is a fact of contemporary American politics. It does not, however, necessarily imply abdication, as officeholders possess instruments that potentially limit bureaucratic discretion. Presidents, for example, fill many high-level agency posts with appointees whose preferences closely resemble those of the chief executive. Members of Congress regularly conduct oversight hearings, which are proceedings designed to monitor and, if necessary, redirect agency activity. The presence

Partisanship, Blame Avoidance, and the Distribution of Legislative Pork

majority party advantage in the allocation of federal resources, a relation? ship seemingly at odds with the bipartisan support often enjoyed by distributive policies and pragrams. We reconcile this disjuncture by developing a partisan blame avoidance account of the distribution of legisla? tive pork. According to this account, the majority party inoculates itself against minority party charges of wasteful spending by including the minority in pork barrel coalitions. At the same time, the majority party, mindful of the electoral benefits of

Information Technology, Political Participation, and the Evolution of Chinese Policymaking

Although information technology is playing a fundamental role in Chinas political development, relatively little is known about the contours of online participation in government policymaking. This article presents the results of a survey of individuals who, in 2008, used the Internet to submit comments on the central governments plan to reform the nations health system. The responses demonstrate that participants were, in the aggregate, well-educated professionals who live in urban areas and were especially likely to work in the medical and health industry. Substantial numbers of participants commented as a means of expressing concerns about the overall direction of reform, as well as on specific elements of the proposal itself. Participants generally anticipated no more than a modest degree of government responsiveness, although high expectations were held for comments from government officials and individuals who worked in the medical and health industry. Overall, these attributes and attitudes are illustrative of the evolution, as opposed to transformation, of the political system that is occurring in online contexts where neither democratization nor the legitimacy of the Chinese Communist Party is of immediate salience to government officials and societal stakeholders.

Health system reform and political participation on the Chinese Internet

Authoritarian regimes, such as the Chinese Communist Party (CCP), seek to bolster legitimacy by facilitating communications between citizens and government officials. This article investigates the operation of online consultation, a process through which citizens offer feedback on draft laws and regulations. The article specifically examines the importance of demographic characteristics and subjective motivations in the expression of citizen sentiments in response to a proposed revision to China’s health system. By bringing together analysis of the content of citizen sentiment with a survey of participants, the article illuminates the determinants of the tone and substance of citizen feedback in health system reform. The primary finding is that participants who were internally efficacious and democratically oriented were, relative to respondents not possessing such traits, positive in tone and highly substantive in the submission of their comments concerning health system reform. This finding indicates that the health system reform commenting process offered citizens the opportunity to gain exposure to democratic principles and the process of articulating interests. More broadly, the analysis suggests the promise of online consultation in promoting citizen satisfaction with public policies, the legitimacy of the CCP, and, ultimately, stability in the Chinese political system.

Police Patrols and Fire Alarms: An Empirical Examination of the Legislative Preference for Oversight

Over the past several decades, the police patrol-fire alarm dichotomy, and corresponding logic that legislators generally prefer fire alarms to police patrols, has been widely circulated and debated. Despite this attention, researchers have devoted relatively little attention to (1) distinguishing these forms of oversight empirically and (2) verifying that legislators utilize fire alarms more regularly than police patrols. We take up these challenges by establishing a set of decision rules for coding hearings as either event-driven or routine, ongoing legislative activities. We then employ this empirical distinction as a means of appraising the relative prevalence of police patrols and fire alarms in the United States Congress, both as a general matter as well as across chambers, committees, political parties, and election cycles. Our central finding is that hearing activity is predominantly police-patrol in orientation. Although this result suggests that legislators do not have a systematic preference for fire alarms over police patrols, such a conclusion can be stated only in the context of hearings, an undeniably important form of oversight.

Markets, Governments, and HMO Development in the 1990s

This article examines the impact of population demographics, health market characteristics, and government purchasing and regulation on the development of the HMO industry in the 1990s. I focus on two facets of development-HMO market share and the number of HMOs in operation in metropolitan areas. My central findings are threefold: Population size is a critical determinant of development. Health market characteristics such as hospital expenditures and physician supply affect development, but often in ways that differ from previous periods (e.g., development is greater in areas with relatively large numbers of specialists). Both government purchasing and regulation affect development, but in ways that may be contradictory in motivation and outcome (e.g., state officials seek to contain costs through Medicaid and Medicare managed care and to enhance consumer protection and satisfaction through regulations such as coverage requirements). These results imply that in a period in which development is increasingly occurring in areas that may have unfavorable markets, policy makers (unlike in earlier eras) influence HMO supply and demand, through their roles both as purchasers and as regulators of managed care.

Political and Organizational Determinants of Bureaucratic Responsiveness

This article examines the responsiveness of the Health Care Financing Administration (HCFA) to contacts initiated by members of Congress, interest groups, and private citizens. I develop and test hypotheses regarding the importance of internal bureaucratic factors (e.g., workload) and external political forces (e.g., contactor characteristics). Although previous research, which focuses on urban service bureaucracies, indicates that procedurally neutral rules related to agency missions are the primary predictors of responsiveness, I demonstrate that political considerations exerted substantial influence over HCFA responsiveness. For example, the agency was in some ways more responsive to congressional contacts than to contacts initiated by groups and citizens. These results suggest that scholars of legislative-executive relations should pay more attention to contacts as these routine, ongoing encounters may affect the extent to which bureaucratic policy choices are consistent with the preferences of elected officials and their constituents.

S alience, complexity and state resistance to federal mandates

Professor of Political Science, 1998The George Washington University Courses include: Legislative Politics, Introduction to American Government, American Political Process, Interest-Group Politics, Executive-Legislative Relations, Positive Theories of American Government, Domestic Public Policy, Congress and Foreign Policy, Congress and National Security Policy, Positive Theories of American Political Institutions, Systematic Inquiry/Research Design, Methods of Political Analysis.

Unifying Rule-Making Information: Recommendations for the New Federal Docket Management System

In recent years, regulatory agencies, Congress, and the White House have taken steps to increase the use of information technology in the management of the rulemaking process. The latest such “e-rulemaking” effort is the design of a new, government-wide regulatory information system being developed by Bush Administration. The system, known as the Federal Docket Management System, will for the first time make all information pertaining to federal regulation available to the public via the Internet. By making information about government regulation available on-line, the Administration’s eRulemaking Initiative seeks to improve the quality and legitimacy of the government’s regulatory decisions. If developed properly, the Initiative’s new on-line docket management system can also facilitate academic research that in the longer term should improve regulatory policymaking. The recommendations in this paper, joined by a group of fifty-five other scholars of regulation, were originally delivered in a letter to the Office of Management and Budget, which is spearheading the Administration’s eRulemaking Initiative. The paper describes the information currently maintained by government agencies and emphasizes the importance of ensuring that no loss of information occurs in making the transition to the on-line system. It also offers steps that the Administration should take to ensure a high level of quality of the information stored in the new system as well as effective search and downloading capabilities.