The power of expertise? Politician–bureaucrat interactions, national budget transparency and the Israeli health care policy

Abstract

How do ministry of Finance (MOF) bureaucrats preserve their dominance in the national budget process? As we all know, MOF bureaucrats are important in politics and policy, we know much less about exactly how they play their role. Political analysis of the interaction between politicians and bureaucrats in the Israeli healthcare policy arena reveals asymmetry of information in favour of the bureaucrats at the MOF. Among others, this asymmetry is also due to a lack of transparency in the national budgeting process. While presenting the balance of power between the players in the Israeli health policy arena, we point to the MOF bureaucrats as the most dominant players – though their power is not absolute as it always seems. Quite a few indications point at ‘non-democratic’ strategies made by these bureaucrats in their interactions with the other players. The empirical findings show that alongside bureaucrats' expertise, strategies based on concealment, manipulation in presentation of information, lack of transparency and ‘Buying’ politicians (bribe for budgets) establish the dominance of MOF's bureaucrats in the policy arena. Under the structural conditions of centralisation, the other players tend to find alternative solutions for promoting the public policies they seek.