Why meta-regulation matters for public health: the case of the EU better regulation agenda.
Why meta-regulation matters for public health: the case of the EU better regulation agenda.
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DOI：
10.1186/s12992-023-00971-4
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发表时间：
2023-09-14
影响因子：
10.8
通讯作者：
Brooks, Eleanor
中科院分区：
文献类型：
--
作者：
Lauber, Kathrin;Brooks, Eleanor
关键词：
在卫生政策的研究中，元管制——管理如何制定和审查个别政策的规则——没有受到太多关注。我们认为，这些规则远不是价值无关和客观的，它们有很大的潜力影响政策产出，从而影响健康结果。引导和操作更广泛的范式，如新自由主义，他们决定，例如，什么被认为是“好”的政策，如何做出决定，基于哪些证据，以及谁的声音重要。探讨元监管的一个典型例子，即欧盟的更好的监管议程，我们说明了为什么元监管工具，如影响评估、利益相关者咨询和评估——以及作为其应用基础的规范——对健康很重要。在此过程中，我们特别关注更好的监管可能影响利益集团施加影响的能力的方式，以及相反，行为者如何寻求形成更好的监管。我们认为，对元监管的关注有助于在全球化与健康交叉点的辩论中平衡对机构的关注，特别是对监管实践和协调的辩论。虽然研究已经注意到，例如，“更好的监管”框架的起源，以及在贸易和投资协定中越来越多地纳入“良好的监管实践”条款，但很少有人关注这些框架一旦制度化所起的作用。然而，正如我们所说明的那样，元监管有相当大的空间，可以通过例如将健康的（社会、经济、政治、商业）决定因素概念化来增强我们对形成卫生政策的力量的理解。因此，我们呼吁更多地关注元调控在旨在改善人类和地球健康的研究和实践中的作用。
Meta-regulation – the rules that govern how individual policies are developed and reviewed – has not received much attention in the study of health policy. We argue that these rules, far from value-free and objective, have significant potential to shape policy outputs and, as such, health outcomes. Channelling and operationalising wider paradigms like neoliberalism, they determine, for instance, what is considered ‘good’ policy, how decisions are made, based on which evidence, and whose voices matter. Exploring an archetypal example of meta-regulation, the European Union’s Better Regulation agenda, we illustrate why meta-regulatory tools such as impact assessment, stakeholder consultation, and evaluation – and the norms that underlie their application – matter for health. In so doing, we concentrate especially on the ways in which Better Regulation may affect interest groups’ ability to exert influence and, conversely, how actors have sought to shape Better Regulation. We argue that attention to meta-regulation contributes to counter-balancing the focus on agency within debates at the intersection of globalisation and health, and notably those on regulatory practices and coordination. Whilst research has noted, for instance, the origins of frameworks like Better Regulation and the increasing inclusion of 'good regulatory practice' provisions within trade and investment agreements, less attention is directed to the role that these frameworks play once institutionalised. Yet, as we illustrate, there is considerable scope for meta-regulation to enhance our understanding of the forces shaping health policy via, for instance, conceptualisations of the (social, economic, political, commercial) determinants of health. As such, we call for increased attention to the role of meta-regulation in research and practice aimed at improving human and planetary health.
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