Comparative politics:
Ana Rico, Associate Professor
Department of Health Management and Health Economics
ana.rico@medisin.uio.no
2005
Theories and methods
OUTLINE
I. Health politics: Content, motivation and goals of the course
II. Political science and comparative politics: problems & methods
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Problems of political science research
Small-N and Large-N approaches
Comparative politics: “the fuzzy centre”
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From early theories: monocausal + (socioeconomic, cultural or institutional)
determinism
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To multi-causal theories (=“comparative politics”, “political economy”)
IV. Causes of policy change (IVs)
V. Applications (DVs)
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Causes of the expansion of the WS/HC systems in OECD countries
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Causes of retrenchment/restructuring/resilience of WS/HC systems
VI. Course assignments
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Presentation and participation in class (10% + 10%)  1 or 2 per article
Course paper (30%)  Groups 2-4
Exam (50%)  5 December
2005
III. Types of theories:
2005
Health politics:
Contents, motivation
and goals of the course
HEALTH POLITICS: Content and motivation
1. Content and motivation of the course
A) Content
Application of political science theories to the health care sector
Based on the comparative-historical method  tries to build the gap between
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qualitative case-studies and quantitative statistical studies
Focus on how to build and criticise concepts and theoretical arguments
B) Motivation
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Compare health care (HC) with other sectors of the welfare state (WS)
Understand how the WS was built, and which were the causes of its emergence
The main distinctive feature of Europe?
Outside Europe, a lot of interest on how to replicate it
It can also help to understand how to mantain it or expand it further
Some paradoxes...
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Health politics has been developed mainly by US scholars
In Europe, recent and often focused on how to cut back public health care
We know a lot about health policies (e.g. Managed competition), but little on
how to introduce them (health politics)
2005
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HEALTH POLITICS: Goals
2. Goals of the course
A) Conceptual
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Review and classify existing research traditions in political science
Learn how to build and criticise concepts and theoretical arguments in a convincing way
Learn how to build simple causal models out of complex theories and facts
Analyze the political determinants of health policy
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Assess the analytical goodness of fit between theory and evidence (validity)
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Study the causes of health care (and welfare state) reform  policy change
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Focus on how to build universal WS/HC systems, and how to expand them
C) Practical
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Develop analytical skills as well as (experiential) “clinical eye” from reform processes
Learn a new language: concepts of political science and health system research
Learn how to read & systematize a great deal of information very fast
D) Professional
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Design and direct processes of political and policy change in health care
Assess and evaluate complex real world situations in health politics & policy
Advice policy-makers (state, interest groups, professional and patient associations, newspapers),
convince contenders, and build agreements with/among them
2005
B) Empirical
2005
Political science:
Methods and problems
POLITICAL SCIENCE & COMPARATIVE POLITICS
1. Problems of political science (PS) research
1.1. Lack of agreement across schools of thought
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1.2. Many variables, few cases
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Object of study involves complex macro-social phenomena (e.g. WS) characterized by:
Multidimensional concepts, meaning varies across time & place, difficult to operationalize
A great number of potential causes, not independent among them
Long causal chains and complex causal mechanisms
Feedback effects, endogenous causation and selection bias (Przechevorski in Kohli)
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Object of study (e.g. WS) often occurs only in a few cases (e.g. OECD countries)

Difficult to build simple concepts and models that can be tested across cases (reliability), but still
resemble real world complexity (validity)
But need to address both: Science of politics (build and test scientific models) and Science
for politics (advice politicians based on real world complexity) (T. van der Grinten)

2005
Divided across theoretical (which particular cause they emphasize) and ideological lines: marxism,
liberalism, structuralism, culturalism, pluralism, institutionalism, rational choice…
Little communication, often tough competition and rivalry between them
Lack of agreement on how to define & operationalize basic terms
E.g. Institutions
POLITICAL SCIENCE & COMPARATIVE POLITICS
 Three methodological approaches to adress such problems
Narrative case-study (N=1) approach
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Statistical (large N) analysis
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Too many cases to know in-depth what happened in each of them.
Too little variables taken into account, simple or no causal mechanisms
External validity goes at the cost of internal validity
The comparative method: medium-N (N=2 or more)
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Seeking a balance between number of cases and number of variables
Seeking a balance between internal validity and external validity
The goal is to build general theories, but based on cases researched in depth
The research design is quasi-experimental
Research techniques can be qualitative or/and quantitative
2005
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Qualitative, in-depth study of a single case
Internal validity high but ad-hoc explanation, low reliability
No generalisation or theory-based explanation possible
POLITICAL SCIENCE & COMPARATIVE POLITICS
1. Case(=country)-based: Small-N (=1) studies, e.g. US Welfare State
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Old research tradition: historical, in-depth analysis of one case-study
It simplifies by reducing N so that all or most potential causes can be analysed
It allows a detailed analysis of:
Specific characteristics of countries (e.g unique, model causes)
complex causal mechanisms, and
time sequence of events

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GOOD INTERNAL VALIDITY (causes represent well real world complexity),
BUT
 Little external validity (causes cannot be tested/applied to other cases)
It does not allow to discriminate between general and country-specific factors
It is the preferred method of theories based in cultural relativism
It fits well their main assumptions
-
unique causal mechanisms apply in each case
optimal policy change results from internal, country-based trial and error
Social constructivism and some institutionalist approaches are examples of cultural
relativism
It can also be used to make general theories – based on the comparative method
2005
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POLITICAL SCIENCE & COMPARATIVE POLITICS
2. Variables-based: Large-N studies, e.g. Causes of democracy
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New research trends (modelling): study a few variables across a large number of cases
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It simplifies by (1) selecting a few variables considered as key causes
(2) reducing complexity or variability by making restrictive assumptions
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Cross-national statistical studies are the main example (over 100 countries)
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GOOD EXTERNAL VALIDITY (under tight, often unrealistic assumptions), but
Little internal validity: too many omitted (=extraneous) variables, disregards variables which
are difficult to measure (often the most relevant), model is not a fair image of reality,
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It is used by many schools that believe we can find general regularities across cases
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The most radical is rational choice analysis & game-theory, which works best when the
restrictive behavioural assumptions of classic economics apply:
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all individuals behave in their own self-interest;
under complete rationality and
perfect information
New, sophisticated methods can avoid some of the pitfalls
If N decreased, and qualitative info added, similar to the comparative method
2005
(eg all the causes are independent of each other; the causes are independent of the effects;
causal sequence does not matter
POLITICAL SCIENCE & COMPARATIVE POLITICS
Causal mechanisms in
small-N case-studies
Causal mechanisms in
large-N case-studies
Self-interest
Assumptions:
eg Behaviour
ß1
ß2
ß4
Social
interaction
Norms &
values
E
2005
ß3
POLITICAL SCIENCE & COMPARATIVE POLITICS
3. The comparative-historical method
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“Thinking without comparison is unthinkable” (Swanson, 1971; quoted
by JK Helderman)
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Seeks a balance between N and number of variables:
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N=1 (+ reference case/s). Case-study treated comparatively
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Ideal type (+ rest of cases)  Often example of best practice
Deviant/critical case (+ average case)  Causal mechanisms
contradict establised, general theory
N=1 [Sector 1/Sector 2; Time period 1/Time period 2]
N=2, 3, 4. Matched comparisons
N > 4. Requires:
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Combination of quantitative/qualitative. QCA, OLS
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Secondary qualitative/historical evidence on N>4 cases
Seeks a balance between internal validity and external validity
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Goal: build general theories, based on cases researched in depth
The research design is often quasi-experimental (note OLS too)
2005
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Most-similar cases (method of difference)
Case 2
A
B
C
Not X
Outcome Y
Outcome not Y
Main cause (X) is present in one case and missing in the other.
Both cases are similar (matched) in all other respects. The main
effect Y is present when X present, and absent when X is absent
(points to a necessary and sufficient cause).
2005
Case 1
A
B
C
X
Case-study, before-after design
Case 1, T0
A
B
C
X
Outcome not Y
Outcome Y
Main cause (X) is present in one case and missing in the other.
Both cases are similar (matched) in all other respects. The main
effect Y is present when X present, and absent when X is absent
(points to a necessary and sufficient cause).
2005
Case 1, T0
A
B
C
Not X
Most-similar, graduation in cause-effect
Case 1, Sector
2
A
B
C
X=1
Y=1
Case 1, Sector
3
A
B
C
X=2
Y=2
Main cause (X) is present to different degrees in two cases and
missing in the other. The cases are similar (matched) in all other
respects. The effect Y is present when X present, and its
graduation corresponds to X´s one (additional evidence of
necessary and sufficient cause).
2005
Case 1, Sector 1
A
B
C
X=0
Not Y
Close to most-similar, N=4
Case 2
A
C
D
Not X
Not Y
Case 3
A
B
D
X
Y
Case 4
A
B
E
Not X
Not Y
Main cause (X) is present in two cases and absent in the other
two. The cases are only imperfectly matched, but rest of potential
causes do not correspond to the effect (can be necessary or
suficcient, but not both). The effect Y is present when X present.,
absent when is absent (necessary and sufficient cause).
2005
Case 1
A
C
E
X
Y
Most-different cases (method of agreement)
Case 2
B
D
F
X
Outcome Y
Outcome Y
Main cause (X) is present in both cases. They are very different
in all other relevant respects. This suggests that the effect Y
always occurs when X is present (necessary cause); the rest of
factors can be irrelevent or sufficient causes.
2005
Case 1
A
C
E
X
POLITICAL SCIENCE & COMPARATIVE POLITICS
3. The comparative-historical method (cont.)
It can be used for explanatory, descriptive and prescriptive analysis:

A. Under a quasi-experimental research design, it can be used for
inference (explanatory studies)  Matched comparisons, QCA, OLS

QCA offers some advantages over OLS (Mahoney), eg:
It allows for the different categories of a tipology - as the DV (eg:
Esping-Andersen and the three worlds of welfare capitalism) being
explained by different combinations of causes
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B. Less strict, more qualitative comparisons can be used for
descriptive and prescriptive purposes, e.g.:
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Concept formation and categorization: e.g. Definition and types of
WS, the concept of representation (Pitkin)
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Operazionalization of complex concepts: e.g. Democratic
institutions (Executive/Parliament Dominance, Federal/Unitary,
Majoritarian/ConsotiationalProportional, Corporatism/Pluralism) 
Liphart
2005
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POLITICAL SCIENCE & COMPARATIVE POLITICS
3. The comparative-historical method (cont.)

B. Less strict, more qualitative comparisons used in descriptive and
prescriptive purposes, e.g. (CONT.):
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 Complex causal mechanisms
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Mapping and comparing policy alternatives for policy-makers
Studying the key causal mechanisms of a case of best practice in
order to imitate it
Uncovering specific temporal sequences of events in the history of
a deviant case: to facilitate removal of obstacles to change
2005
Building hypothesis and evidence on:
 Complex case-specific interactions between IVs
 Effect of historical accidents as sufficient causes
 Temporal sequences of causes
CAUSAL MECHANISMS IN COMPARATIVE POLITICS
Sociopol.
actors
Political
actors
Institutions & Resources
Process,
interact.
Policy
2005
Context
2005
Types of theories
TYPE OF THEORIES & CAUSES OF POLICY
III. Types of theories:

From early theories: monocausal + (socioeconomic, cultural or institutional)
determinism

Good for advising/influencing policy-makers
Often professional interests/ideology of researchers
Limitations of quasi-experimental, qualitative comparisons
Little information available
To multi-causal theories (=“comparative politics”, “political economy”)
IV. Causes of policy change (IVs)
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1. Structural, cultural and convergence theories: SOCIAL CONTEXT (audience)
2. Actor-centred theories: POLITICAL ACTORS (=players/teams/clubs)
3. Institutionalist theories: INSTITUTIONS (= rules of the game)
4. Action-centred theories: INTERACTIONS (=game/league)
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5. Policy-centred theories: PATH DEPEPENDENCE, FEEDBACK, LEARNING
CONCEPTUAL COMPLEXITY INCREASES
2005
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POLITICAL SCIENCE & COMPARATIVE POLITICS
Exercise: Amenta et al. 2004
Types of theories
EUROPE-BASED EXPLANATIONS
• Modernization & ec.development
1. Context theories:
 Structural,
• Coalition theories
 Cultural
• Institutional theory: centralization/
/fragmentation of the polity
 Convergence theories:
• State-centred theory: state capacity
and autonomy; state bureaucracy
• Path-dependency, policy feedbacks
US-BASED EXPLANATIONs_
• Race
• Social movements (citizens. mob.)
 2. Actor-centred theories:
 Interest groups
 Political parties
 State-centred
 State-society: civil society
 3. Institutionalist theories:
• Interest group theory: capitalists
 4. Process-centred theories:
• Public opinion
 5. Policy-centred theories:
• Patronage, non-ideological pol. parties
 Path dependence,
• Democratic polity: openess & access
 Policy feedbacks & policy learning
2005
• Partisanship theory (SD, CD)
2005
Causes of policy change
CAUSES OF POLICY CHANGE:
Operationalization in WS/HC research
 Access & participation
 Policy strategies
 Coalition-building
 Competition and cooperat.
 Changing resources
 Learning
 Conjunctural
CONTEXT
 Interest groups
 Profesional assocs.
 Poilitical parties
 State authorities
 Citizens: PO/SM
 Mass media
Preferences
Resources
 Distrib. of formal pol. power:
electoral law, constitution, federalism,
corporatism
 Contracts and org. structures
 Norms of behaviour
 Sanctions/incentives
POLITICS:
Interactions
Process
POLITICAL ACTORS
INSTITUTIONS
Individual and collective
-
Formal and informal
POLICY
Adapted from Walt and Wilson 1994
Entitlements & rights
 Regulation by law (of power, ownership,
financing, behaviour, contracts)
 Redistribution: Financing & RA
 Production of goods & services
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2005
•
factors: ec crisis, wars
• Socioeconomic structure:
• Ownership, income
• Education, knowledge
• Social capital (status, connections)
• Sociopolitical structure:
• Cleavages and political identities
Values: Culture and subcultures
2005
Assignments
ASSIGNMENTS
Presentation and participation in class (10% + 10%) 
 1 or 2 students per article
 1 or 2 presentations
 Summary, partly based on graphic tools
Course paper (30%)  Groups 2-4
 History of Norwegian WS/HC compared with other case
 Recent reforms expanding the HC sector compared with case
Exam (50%)  5 December
 Concepts and theories
 Text to discuss
2005
 Criticisms: to unclear or overstretched concepts, unconvincing
arguments, counterarguments, lack of correspondence between concepts
and evidence, insufficient evidence, important omitted variables, others
ASSIGNMENTS
Ana Rico
The social context of health
politics
Mechanic & Rochefort 1996
Bouguet 2003
Svallsfors 1997
Wed. 28 sep.,
13:15-16:00
Ana Rico
Interest groups and political
parties
Olsen 1982
Quadagno 2004
Hunold 2001
Wed. 5 Oct.
10:15-12:00
Student-led
session
Case 1: Interest groups in the
US WS;
C2: Corporatism and
professional selfregulation in EU HC.
Navarro 1989
Quadagno 2004
Greß et al. 2004
Blom-Hansen 2000
Wed. 5 Oct.,
13:15-16:00
Ana Rico
The role of the state:
government, parliam-ent,
and bureaucracy
Skocpol 1980
White 2003
Howlet & Ramesh, ch.2.
Wed. 12 Oct.,
13:15-16:00
Ana Rico
Civil society: policy experts,
public opinion and massmedia
Hall 1993
Manin 1989, ch6
Hoffman 2003
Wed. 19 Oct.,
10:15-12:00
Student-led
session
Case 3: The political economy
of the WS in US, UK &
Sweden
Case 4: Mass media & public
opinion in Clinton’s HC
reform
Hall 1993
Weir & Skocpol 1983
Jacobs 2001
Goldsteen et al 2001
2005
Wed. 21 Sep.,
13:15-16:00
ASSIGNMENTS
Ana Rico
Institutions: Division of powers,
veto points and regulation
Immergut 1992
Scharpf 2000
Wed. 26 Oct.,
13:15-16:00
Ana Rico
Action theories and the political
process
Korpi 1989
Garrett 1993
Rico & Costa 2005
Wed. 2 Nov., 10:1512:00
Student-led
session
Case study 5: HC expansion in
the UK, the US, and Canada
Case study 6: The origins of
the US WS
Jacobs 1992
Maioni 1997
Briggs 2000
Jenkings and Brents 1989
Wed. 2 Nov., 13:1516:00
Ana Rico
The new welfare/health politics
and the debate on
retrenchment
Pierson 1996
Clayton & Pontusson 1998
Tuhoy 1999
Wed. 9 Nov., 10:1512:00
Student-led
session
Case 7: Evidence on
retrenchment in WS
Case 8: Politics of
retrenchment in HC
Korpi 2003
Allan & Scruggs 04
Hacker 2004
Oliver 2004
2005
Wed. 19 Oct.,
13:15-16:00