Poster #49 - Federalism and Local Governments: The United States and India as Examples of Opioid Spending Policies

• In Event: Friday Poster Reception

Abstract

The opioid epidemic caused markedly harmful addiction related outcomes in the United States. India is arguably experiencing an opioid epidemic similar to the United States; however, India’s unique governmental structure and strategies for federal disbursement of funds to local governments provides a contrast to the American federalist system of spending and disbursement. Moreover, both nations serve as symbolic leaders of continuing democracy on the global stage. India is the largest democracy in the world whereas the United States is the oldest democracy. India, however, operates as a more cooperative federalist government that is neither purely federal nor unitary. Differences in democratic philosophy between these two nations yields varying policy outcomes at local levels in the context of federal influence on local spending. To address these distinctions, this paper will provide a narrative comparison, including an overview of cooperative federalist theory, of these two democratic systems through the lens of healthcare spending policies that attempt to combat opioid addiction. The case study will specifically address how local governments interact with federal and state entities and how such interactions influence localized policy. The narrative analysis will provide insight into gradations of federalist systems of government and how differing characteristics of federalism within a democratic system impacts policy effectiveness at local levels.

Factors to be considered in the comparative analysis:

·      India’s identity as a cooperative federalist system of government

·      The impact of India’s unitary constitution (verses individual state constitutions found in the United States) and how this distinction impacts flow of federal funds to localities

·      How each country views separation of powers

·      How American bipartisanship impacts localized politics juxtaposed to the greater quantity of impactful political coalitions in the India example

·      How changes in center and state relations in India currently impacts localized policy

·      The unique power of the Lok Sabha

·      Increasing competitive federalism in the Indian context

·      How localities must respond to federal mandates in both national contexts

For a specific example, in the American context, as a result of state level class action litigation, a federal settlement fund was created to assist states in funding and implementing policy initiatives to rectify the opioid epidemic within local jurisdictions. Correspondingly, this chapter will illustrate the nuances of the American federalist system and how opioid settlement funds flow from the American federal government to localized communities. In contrast, the nature of India’s Constitution and cooperative federalist system lends to more localized authority of healthcare spending and addiction abatement. Arguably, transfer of authority to the federal government of India could simplify administration of opioid abatement policies but decrease local discretion.

In essence, this paper takes a step to develop an answer to the question of how federalist systems of government impact local policies in the context of opioid addiction as a public health concern. Because of the relevant nature of the opioid crises, this analysis is ripe for future utilization in academic discourse addressing effectiveness of use of federal funds in democratic nations.

Author

• Georgia Litle, University of Oklahoma
  Presenting Author