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German centralization strategy during COVID-19: Continuing or interrupting a trend?

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  • 1Dr. Andreas Lehr - Agency for health-policy information, [GERMAN: Agentur für Gesundheitspolitische Information], Luisenstr. 41, 10117 Berlin, Germany.

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Germany

Keywords:
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Area of Science:

  • Health Policy
  • Political Science
  • Public Health

Background:

  • COVID-19 pandemic prompted health policy centralization globally.
  • Germany observed a vertical shift in health policy decision-making competences.
  • This shift moved power from regional to national levels for infection control.

Purpose of the Study:

  • To analyze health policy regulatory measures in Germany from March 2018 to March 2020.
  • To determine if the observed centralization trend predated COVID-19 and extended beyond infection control.
  • To investigate the horizontal allocation of decision-making competences within national government and non-government institutions.

Main Methods:

  • Quantitative and qualitative analysis of health policy regulatory measures.
  • Examination of the period before and during the COVID-19 pandemic.
  • Assessment of shifts in decision-making competences at national and regional levels.

Main Results:

  • The COVID-19 centralization strategy in Germany did not continue a pre-existing trend.
  • Prior to the pandemic, the focus was on horizontal power distribution within national government and non-government bodies.
  • A long-term trend strengthened government institutions' decision-making power while weakening non-government institutions.

Conclusions:

  • The centralization during COVID-19 was a pandemic-specific response, not a continuation of prior policy trends in Germany.
  • Germany's pre-pandemic health policy landscape was characterized by a strengthening of governmental authority over non-governmental actors at the national level.
  • Understanding these distinct trends is crucial for future health policy and governance reforms.