The leading question in this paper is if one specific structural reform output in the German health system, concrete the institutionalization of the Federal Joint Committee according to the SHI Modernization Act (GKV- Modernisierungsgesetz/GMG) in the beginning of 2004, is an example for building a quasi-governmental institution with limited external political accountability relations which causes an political accountability deficit.
This paper is grounded on the content and theoretical focus of the seminar Accountability, democracy and management in the welfare state, which I attended at the University Potsdam in summer semester 2014. It deals with the issue of using a couple of premises from the academic field of accountability to analyze one specific output of a reform in the German health care system in relation to the founding and the work of the Federal Joint Committee (Gemeinsamer Bundesauschuss/ G-BA) since 2004.
Table of Contents
1. Introduction
1.1 Relevance
1.2 Approach
2. Public Accountability as analytical framework in health system
2.1. Framework for analysing political accountability
2.2. Indicators for accountability deficits
3. The Federal Joint Committee in the German health care system
3.1. Legal status & effects on accountability relations
3.2. Insufficient Interest Representation & Intransparency
3.3. Conclusion-an example for weak political accountability and an accountability deficit?
4.Bibliography
Research Objectives and Topics
This paper aims to analyze whether the Federal Joint Committee (G-BA) in the German health care system, established by the SHI Modernization Act of 2004, constitutes a decoupled institution that suffers from a significant political accountability deficit due to limited external control and transparency.
- The theoretical concept of public accountability in health care systems.
- The institutional background and legal status of the Federal Joint Committee.
- The analysis of democratic legitimacy and citizen interest representation.
- Evaluation of hierarchical control mechanisms and accountability relations.
Excerpt from the Book
1. Introduction
This paper is grounded on the content and theoretical focus of the seminar Accountability, democracy and management in the welfare state, which I attended at the University Potsdam in summer semester 2014. It deals with the issue of using a couple of premises from the academic field of accountability to analyze one specific output of a reform in the German health care system in relation to the founding and the work of the Federal Joint Committee (Gemeinsamer Bundesauschuss/ G-BA) since 2004.
The leading question in this paper is if one specific structural reform output in the German health system, concrete the institutionalization of the Federal Joint Committee according to the SHI Modernization Act (GKV-Modernisierungsgesetz/GMG) in the beginning of 2004, is an example for building a quasi- governmental institution with limited external political accountability relations which causes an political accountability deficit.
In this context we need at first take a closer look on the often used term accountability to get a better picture of its various meanings and circumstances of use in the literature, society and the media, so we have to briefly describe the meanings of the terms accountability, democratic and political accountability and accountability deficit. Accountability is nowadays often used to describe a social relationship between organizations or individuals who feel an obligation to explain and to justifiy his or her conduct towards other actors. Though it can be defined as “a social relationship in which an actor feels an obligation to explain and to justify his or her conduct to some significant other “. It could be also said that it is all about “[..] holding agents to account for meeting standards and expectations of various principals- including executives , legislatures[…] and various publics.“
Summary of Chapters
1. Introduction: This chapter introduces the research focus on the Federal Joint Committee and frames the investigation within the academic field of accountability and democratic management.
2. Public Accountability as analytical framework in health system: This section defines the theoretical framework for analyzing accountability and provides indicators to detect potential deficits in institutional settings.
3. The Federal Joint Committee in the German health care system: This main part examines the specific legal and organizational structure of the G-BA to evaluate whether its independence from direct government control leads to a democratic deficit.
4.Bibliography: This section lists all academic literature and internet sources cited throughout the paper.
Keywords
Accountability, Federal Joint Committee, G-BA, SHI Modernization Act, Health Care Reform, Political Accountability, Accountability Deficit, Self-Administration, Democratic Legitimacy, Interest Representation, Transparency, Governance, Quasi-governmental Institution, Public Administration, Statutory Health Insurance.
Frequently Asked Questions
What is the fundamental focus of this paper?
The paper examines the institutional structure of the Federal Joint Committee (G-BA) in Germany to determine if it operates within sufficient political accountability frameworks.
What are the central thematic fields addressed?
The research centers on public accountability, the German health care system, democratic management, and the legal status of quasi-governmental institutions.
What is the primary research question?
The study asks whether the institutionalization of the Federal Joint Committee, as mandated by the 2004 SHI Modernization Act, has resulted in a political accountability deficit.
Which scientific methodology is employed?
The author utilizes an analytical framework of political accountability, applying specific indicators to assess the independence, transparency, and responsiveness of the G-BA.
What topics are discussed in the main part?
The main section analyzes the G-BA’s legal status, its independence from the Federal Ministry of Health, and the challenges regarding interest representation and the lack of democratic control.
How is the research characterized by its keywords?
The work is defined by terms such as accountability deficit, self-administration, statutory health insurance, and institutional governance.
Does the G-BA fall under direct supervision of the Federal Ministry of Health?
No, the G-BA is described as a discrete public legal entity with a self-administrative character, which limits the hierarchical control usually expected of government agencies.
Why does the author conclude that there is an accountability deficit?
The conclusion points to a lack of forums for sanctions, limited transparency, and the absence of direct democratic mechanisms like elections for its members.
- Citation du texte
- Malte Jannik Jacobs (Auteur), 2014, The Federal Joint Committee in the German health system. Political accountability deficit caused by a decoupled government institution?, Munich, GRIN Verlag, https://www.grin.com/document/313546
