Federalism and public health decentralisation in the time of COVID-19

Pietrangelo de Biase ; Sean Dougherty

Organisation for Economic Co-operation and Development

关键词: fiscal federalism;    intergovernmental coordination;    public health services;    Coronavirus;    subnational governments;   

DOI  :  https://doi.org/10.1787/b78ec8bb-en

学科分类：社会科学、人文和艺术（综合）

来源: OECD iLibrary

【 摘 要 】

The Coronavirus pandemic has put extreme pressure on public health services, often delivered at the local and regional levels of government. The paper focuses on how countries made changes to the configuration of federalism during the first wave of the pandemic. These changes typically have involved the centralisation and decentralisation of certain health-related activities, as well as the creation of new coordination and funding mechanisms. Specific tools that have been used include an enhanced role of the executive branch (“executive federalism”), the use of centres of government for vertical coordination, as well as the introduction of unique state-of-emergency laws. New horizontal coordination arrangements have also emerged with the more decentralised approaches. The strengths, weaknesses and implementation risks of various approaches are analysed using country examples.