Articles & Working Papers

“Supply-Side Policy Feedback: Public Sector Unions and Public Services for the Disadvantaged” (Working Paper)

Despite weak demand, governments sometimes provide generous public services to disadvantaged client groups. This article points to the underexplored role of public sector unions in these cases. Absent powerful clients, the maintenance and expansion of public services can depend on the political activity of public employees. Their trade unions advance policies that raise wages, protect employment, and feed resources back into public services. Although many factors can condition the influence of government employees, here I focus on just one: public workers’ ability to organize with their managers. Where a public labor-management coalition forms, governments can maintain and expand services. Where it does not, negative feedback ensues.

"Why States Do or Do Not Privatize: Cross-Class Coalitions in the Public Sector" (Working Paper, with Trevor Brown)

The privatization of the state is widespread and increasing under advanced capitalism. Yet the scope and scale of restructuring varies. When do public services privatize, and when do they remain in the public’s hands? The authors argue that one explanation lies in a counterintuitive coalition: that of labor and management. Unlike industrial relations in the private sector, those of the public sector are not necessarily antagonistic. When the interests of public sector workers and managers—the latter defined as those with responsibility over staffing levels—are aligned, public services are less susceptible to privatization. Conversely, when the interests of workers and managers are not aligned, governments attempting to privatize a public service are able to do so. To test and substantiate this theory, the authors deploy Mill’s method of difference to examine three case studies, focusing on efforts to restructure public passenger rail in the liberal market economies of the United States, the United Kingdom, and New Zealand at the onset of the privatization era in the 1980s and 1990s. Extending arguments about the role of management in comparative political economy from the private to the public sector, this paper also has implications for the study of both cross-class coalitions and the public sector in post-industrial knowledge economies.

2022. Isabel M. Perera. "Interest Group Governance and Policy Agendas," in Governance [PDF]

  • APSA Health Politics Section Leonard S. Robins Best Paper Award, 2018

  • LSE International Health Policy Conference Best PhD Paper Award, 2017

This article proposes that the internal political organization of an interest group can shape its policy agenda. In doing so, it recommends that public policy research draw on scholarship on comparative political institutions to identify and theorize how alternative organizational rules, structures, and mechanisms can shape preference formation and expression. For example, confederal interest groups can amplify minority voices, whereas majoritarian groups can silence them. Contrasting cases of physician advocacy in mental health policy illustrate how the confederal approach to medical organization in France expanded the influence of a small group of public sector psychiatrists; while the majoritarian, “winner-take-all” approach to medical organization in the United States sidelined their American counterparts in favor of the private sector majority. These findings suggest that the politics of interest-aggregation merit further investigation.

2021. Bailey Rose-Marie Fairbanks, Fabian Neuner, Isabel M. Perera, and Christine M. Slaughter. “Pay to Play? How Reducing APSA Division Fees Increases Graduate Student Participation," in PS: Political Science & Politics. [PDF]

In 2017, the American Political Science Association (APSA) Committee on the Status of Graduate Students in the Profession launched an initiative to lower the cost of Division (i.e., organized section) membership for students to promote graduate students’ professional development and to advance Division interests. This article assesses the effect of this intervention on Division membership. Using APSA membership data, we find that almost two thirds of Divisions that charged fees in 2017 reduced or eliminated student fees between 2017 and 2019, nearly halving the average student dues (i.e., from $11.57 in 2017 to $5.84 in 2019). As a result, average student membership increased by more than 300% in Divisions that reduced fees (i.e., from 79.5 in 2017 to 248.7 in 2019), compared to a marginal 30% increase in those that did not reduce fees. These outcomes of the initiative support additional efforts to reduce the costs of APSA participation for graduate students.

2020. Isabel M. Perera and Desmond King, “Racial Pay Parity in the Public Sector: The Overlooked Role of Employee Mobilization” in Politics & Society [PDF]

Rising economic inequality has aggravated long-standing labor market disparities, with one exception: government employment. This article considers the puzzle of black-white wage parity in the American public sector. African Americans are more likely to work in the public than in the private sector, and their wages are higher there. The article builds on prior work emphasizing institutional factors conditioning this outcome to argue that employee mobilization can motor it. As public sector unions gained political influence postwar, their large constituencies of black, blue-collar workers, drawing on both militant and nonviolent tactics of the urbanizing civil rights movement, advocated for improved working conditions. Archival sources confirm this pattern at the federal level. The employment and activism of African Americans in low-skilled federal jobs pivoted union attention to blue-collar issues and directly contributed to the enactment of a transparent, universal wage schedule for the blue-collar federal workforce (the Federal Wage System). The result was greater pay parity for African Americans, as well as for other disadvantaged groups.

2021. Isabel M. Perera, "What Doctors Want: A Comment on the Financial Preferences of Organized Medicine," in the Journal of Health Policy, Politics, and Law [PDF]

Organized medicine’s persistent demand for high payments is one factor that contributes to the rising costs of health care. The profession’s longstanding preference for private and fee-for-service practice has pressured payers to increase reimbursement rates in fee-based systems; and it has stalled, thwarted, or otherwise co-opted attempts to contain costs in other payment systems. Yet what doctors want in fact varies. This comment revisits classic comparative studies of organized medicine in the advanced democracies to highlight two under-emphasized findings: (1) physicians’ financial preferences can deviate from traditional expectations, and (2) the structure of the organizations that represent doctors can shape whether and how those preferences are expressed. These findings remain relevant today, as a discussion of contemporary American health politics illustrates.

The logic of French mental health policy—which already stands out against that of other countries—also appears at odds with the usual logic of French social policy. "La sectorisation psychiatrique” rejected the liberalism prominent in the rest of the health system, adopted Beveridgean principles decades in advance of other policy areas, and began to centralize precisely during the period of déconcentration. This article explains these puzzles by pointing to the role of public sector trade unions. Archival sources document how the historical advocacy of unions representing public psychiatric workers shaped public policy in mental health. Examining their political activity can revise standard interpretations of the French welfare state and illuminate a generalizable theoretical relationship for comparative analysis.

2017. Julia F. Lynch and Isabel M. Perera,Framing Health Equity: U.S. health disparities policy in comparative perspective,” in the Journal of Health Policy, Politics, and Law [PDF]

In this article we explore systematically the different conceptions of health equity in key national health policy documents in the United States, the United Kingdom, and France. We find substantial differences across the three countries in the characterization of group differences (by SES, race/ethnicity, or territory), and the theorized causes of health inequalities (socioeconomic structures versus health care system features). In all three countries, reports throughout the period alluded at least minimally to inequalities in social determinants as the underlying cause of health inequalities. However, even in the reports with the strongest attachment to this causal model, the authors stop well short of advocating the redistribution of power and resources that would likely be necessary to redress these inequalities.