Judicialization and Health Policy in Colombia: The Implications for Evidence-Informed Policymaking

Hawkins, B; Alvarez Rosete, A; (2017) Judicialization and Health Policy in Colombia: The Implications for Evidence-Informed Policymaking. Policy Studies Journal. n/a-n/a. ISSN 1541-0072 DOI: https://doi.org/10.1111/psj.12230

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The existence of the tutela mechanism and the endemic weaknesses of the legislative and executive branches of the Colombian state have led to a de facto judicialization of health policymaking. The objective of evidence-informed policy is to identify effective policy approaches and legitimize policy decisions. Questions arise about the basis on which judges take decisions with significant policy and budgetary consequences, and the forms of evidence they use to inform these. This article focuses on the extent to which courts take account of research evidence in judgements and assesses the implications for health policy in Colombia. We place these discussions in the context of a broader analysis of the ongoing reforms to the Colombian health system and the most recent literature on evidence-informed policymaking. The judicialization of health policymaking offers a suboptimal means to achieve the objective of evidence-informed policymaking. The emergence of a range of evidence advisory bodies in recent years is an attempt to address the issue of judicialization alongside the other constitutional and political weaknesses Colombia faces. 考虑到宪法法院对公民个人的监护机制(tutela mechanism), 以及立法和行政部门在地方的弱势, 哥伦比亚的卫生政策形成了事实上的司法化。“基于证据”的政策制定模式对于识别有效的政策工具并促进政策制定的合法化具有重要作用。当我们用“基于证据”的政策制定模式去分析哥伦比亚的宪法法院监护机制, 我们提出两个问题:第一, 法官对重大政策和预算结果做出决定时是以何为基础?第二, 法官们用以决策的证据是何种形式?本文重点研究当哥伦比亚法院在对卫生政策做出决断以及评估时, 会在多大程度上依赖研究证据。为此, 我们拓展我们的研究, 分析了哥伦比亚卫生系统正在进行的改革, 并讨论了关于“基于证据”的政策制定的最新文献。卫生决策的司法化为实现证据决策的目标提供了一种次优的手段。近年来哥伦比亚出现了一系列的证据咨询机构, 这反映出了哥伦比亚对于解决其面临的司法化问题, 以及其他在宪法和政治上的缺点的一种尝试。

Item Type: Article
Keywords: judicialization, evidence-based policy, Colombia
Faculty and Department: Faculty of Public Health and Policy > Dept of Global Health and Development
URI: http://researchonline.lshtm.ac.uk/id/eprint/4645604


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