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Emma Bergstedt

PhD student

My research is about politics and democracy in healthcare governance and allocation of healthcare resources.

Scarcity and allocation of resources is an intractable and recurrent problem in healthcare governance. When healthcare resources are distributed according to explicit priority-setting processes, these decisions are often delegated by elected politicians to technical agencies and experts. This is defended as enhancing the rationality and credibility of the decisions, but also criticised as attempts at depoliticising resource redistribution and avoiding accountability for unpopular decisions. Reliable information and methods are very important when setting priorities but cannot replace negotiation between actors. Priority-setting processes will involve political goals, interests, different ideas about problems and solutions, and different values that structure our beliefs about moral judgments. Systematic approaches to resource distribution that consider both the technical and political aspects of priority setting are important for strengthening democratic practices in healthcare.

My PhD thesis explores politics and democracy in the context of priority setting given the tension between political ideas and technical expertise in healthcare governance. The studies in the thesis investigate different aspects of this balance act in health care governance in Sweden: how explicit priority setting by politicians can consolidate political health care governance; the use of knowledge in policy narratives in national health policy documents; and depoliticisation of resource distribution through the increasing organization of “knowledge-driven management” in health care.