A draconian law: Examining the navigation of coalition politics and policy reform by health provider associations in Karnataka, India

Mishra, Arima and Elias, Maya Annie and Sriram, Veena (2021) A draconian law: Examining the navigation of coalition politics and policy reform by health provider associations in Karnataka, India. Journal of Health Politics, Policy and Law, 46 (4). pp. 703-730. ISSN 0361-6878

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Abstract

A comprehensive picture of provider coalitions in health policy making remains incomplete because of the lack of empirically driven insights from low- and middle-income countries. The authors examined the politics of provider coalitions in the health sector in Karnataka, India, by investigating policy processes between 2016 and 2018 for developing amendments to the Karnataka Private Medical Establishments Act. Through this case, they explore how provider associations function, coalesce, and compete and the implications of their actions on policy outcomes. They conducted in-depth interviews, document analysis, and nonparticipant observations of two conferences organized by associations. They found that provider associations played a major role in drafting the amendments and negotiating competing interests within and between doctors and hospital associations. Despite the fragmentation, the associations came together to reinterpret the intentions of the amendments as being against the interests of the profession, culminating in a statewide protest and strike. Despite this show of strength, provider associations only secured modest modifications. This case demonstrates the complex and unpredictable influence of provider associations in health policy processes in India. The authors' analysis highlights the importance of further empirical study on the influence of professional and trade associations across a range of health policy cases in low- and middle-income countries.

Item Type:	Article
Authors:	Mishra, Arima and Elias, Maya Annie and Sriram, Veena
Document Language:	Language English
Uncontrolled Keywords:	doctors' associations, hospital industry, coalitions, India, health policy
Subjects:	Social sciences > Political Science > Public policy Public Health
Divisions:	Azim Premji University - Bengaluru > School of Development
Full Text Status:	None
URI:	http://publications.azimpremjiuniversity.edu.in/id/eprint/7160
Publisher URL:	https://doi.org/10.1215/03616878-8970895

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