2
organization?
4
Is it the ability of state policy makers to resist rule by state interests because of
independent financial and ideational resources, as measured by policy outputs?
5
In this paper I argue for a definition of state capacity that takes account of the political
development of our hybrid public/private welfare state. The politics of the private welfare state
pose a unique challenge to state policy makers. State success in policy making depends not only
on traditional measures of capacity, such as agency budgets or professionalized legislatures, but
also on the ability of policy makers to understand both private and public systems of social
provision, in this case, both public and employer-based and other private insurance programs.
6
I argue that political parties and labor have been particularly suited to the task of helping
policy makers make sense of health insurance policy and craft reforms. Only parties have
traditionally been “big tents” incorporating various interests and ideas, acting as ideational petri
dishes for the cultivation of creative combinations of public and private reforms. Labor has been
heavily invested at different times with advocating greater public health insurance programs and
more generous employer health plans. Business, on the other hand, unites usually in opposition
to social policy, rather than in support of specific proposals.
7
4
Malcolm E Jewell and Sarah M. Morehouse, Political Parties and Elections in American States, 4
th
ed
(Washington, D.C.: Congressional Quarterly Press, 2000).
5
For the debate, see George J. Stigler, “The Economic Theory of Regulation,” Bell Journal of Economics and
Management Science 2 (1971): 3-21; William T. Gormley, “Regulatory Issue Networks in a Federal system,” Polity
18 (1986): 595-620; William D. Berry, Richard C. Fording, and Russell L. Hanson, “Reassessing the ‘Race to the
Bottom’ in State Welfare Policy: Resolving the Conflict Between Individual-Level and Aggregate Research,”
Journal of Politics 65 (2003): 327-349; Robert S. Erikson, Gerald C. Wright, and John P. McIver, Statehouse
Democracy: Public Opinion and Policy in the American States (Cambridge: Cambridge University Press, 1993);
6
Obviously, “private” health insurance is something of a misnomer, as states are heavily involved in regulation of
employer-based benefit plans. Nevertheless, while governments set the parameters of private action, decisions about
eligibility, and extent of benefits are in private sector hands (employers, unions and some other associations, or
individuals).
7
Theda Skocpol, “The Origins of Social Policy in the United States: A Polity-Centered Analysis,” in eds. Lawrence
C. Dodd and Calvin Jillson, The Dynamics of American Politics: Approaches and Interpretations, (Boulder, CO:
Westview Press, 1994): 182-206, 200-201.
Convention