ABSTRACT – Executive bureaucracies can be used by presidents in multi-party systems to leverage legislative support. What are the identity and capabilities of these political appointees? Why are some executive departments able to cultivate autonomy to innovate in a fragmented political regime, while others are not? We analyzed the Ministry of Health in Brazil, a desired political post in an extremely divided presidential system, examining nominees’ biographies and their autonomy in three different policy areas. We find that health professionals have been remarkably savvy in maneuvering patronage in their favor and occupying strategic managerial posts. Nevertheless, their autonomy plays out differently across departments, which is explained by the ways they have built legitimacy and alliances to support their preferences. These findings challenge theories of political control of the bureaucracy and recent studies of governance that depoliticize the analysis of bureaucracies, contributing to how we conceptualize appointees and the resources available to them.
Texto para Discussão n. 20
Does Increasing Public Spending in Health Improve Health? Lessons from a Constitutional Reform in Brazil
Our results contribute to the literature by providing one of the first wellidentified causal parameters of the relationship between public spending in health and health outcomes