Capitalism, the state and health care in the age of austerity:A Marxist analysis

The capacity to provide satisfactory nursing care is being increasingly compromised by current trajectories of healthcare funding and governance. The purpose of this paper is to examine how well Marxist theories of the state and its relationship with capital can explain these trajectories in this period of ever-increasing austerity. Following a brief history of the current crisis, it examines empirically the effects of the crisis, and of the current trajectory of capitalism in general, upon the funding and organization of the UK and US healthcare systems. The deleterious effect of growing income inequalities to the health of the population are also addressed. Marx’s writings on the state and its relation to the capitalist class were fragmentary, and historically and geographically specific. From them, we can extract three theoretical variants: the instrumentalist theory of the state, where the state has no autonomy from capital; the abdication theory, whereby capital abstains from direct political power and relies on the state to serve its interests; and the class-balance theory of the state, whereby the struggle between two opposed classes allows the state to assert itself. Discussion of modern Marxist interpretations include Poulantzas’s structuralist abdication theory and Miliband’s instrumentalist theory. It is concluded that, despite the pluralism of electoral democracies, the bourgeoisie do have an overweening influence upon the state. The bourgeoisie’s ownership of the means of production provides the foundation for its influence because the state is obliged to rely on it to manage the supply of goods and services and the creation of wealth. That power is further reinforced by the infiltration of the bourgeoisie into the organs of state. The level of influence has accelerated rapidly over recent decades. One of the consequences of this has been that healthcare systems have become rich pickings for the evermore confident bourgeoisie.

Organising for growth:Irish state administration 1958-2008

This paper analyses some key features of Irish public administration as it has developed since the foundation of the state, paying particular attention to the period from the late 1950s onward. During these decades, notwithstanding successive waves of concern expressed over the need for public sector reform, the evidence suggests an underlying lack of coherence in the evolution of the public administrationsystem that resulted in a poor capacity for effective policy coordination. Yet the drive toward economic modernisation also resulted in the creation of new state competence to support industrial development both directly and indirectly. These changes can be tracked organisationally, drawing on the database of the IRCHSS-funded Mapping the Irish State project.

State retrenchment and administrative reform in Ireland: Probing comparative policy paradigms

Policy choices in response to crisis may carry consequences both for distributive outcomes and for the future policy capacity of the state itself. In this paper, we use conceptual heuristics to interpret policy practice. We examine the underlying policy paradigms shaping Irish government decisions in the aftermath of the European financial and economic crisis. We distinguish between two such paradigms- market-conforming and social equity - and apply them to three reform themes: reconfiguration of public budgets, the public service pay bargain, and the organizational profile of state competences. Our findings entail lessons for understanding the malleability of policy choice, and how state policy choices in response to crisis are framed and implemented.

Electric vehicle capacity forecasting model with application to load levelling

There are many uncertainties in forecasting the charging and discharging capacity required by electric vehicles (EVs) often as a consequence of stochastic usage and intermittent travel. In terms of large-scale EV integration in future power networks this paper develops a capacity forecasting model which considers eight particular uncertainties in three categories. Using the model, a typical application of EVs to load levelling is presented and exemplified using a UK 2020 case study. The results presented in this paper demonstrate that the proposed model is accurate for charge and discharge prediction and a feasible basis for steady-state analysis required for large-scale EV integration.