Decision-making in uncertainty: process-tracing Troika influence in creating e-prescription in Greece

DOI: 10.5176/2251-2403_PSSIR18.124

Authors: Julie Kolokotsa

Abstract:

Electronic prescribing is a policy started by the incoming Greek government in 2009 to curb overprescribing. When the financial crisis intensified and policy momentum slowed, leaders placed it in the international agreement to rescue Greece from bankruptcy. The agreement came with conditions and an international team to monitor progress, called the Troika, representing the European Commission, the European Central Bank and the International Monetary Fund. The paper assesses whether process-tracing can help determine ‘the Troika effect’ on e-prescription developments. More specifically, process-tracing is used to investigate whether a hunch related to national leaders using the Troika was a likely explanation for the e-prescription outcome. Leveraging findings analyzed from twenty-four interviews with elite decision-makers, the paper showcases the high likelihood that a behind-the-scenes compromise was agreed to reach swift agreement with the Troika on e-prescription while curbing its ambition. The paper adds a real-life case study on decision-making immediately before and after the arrival of an international organization to enforce austerity conditions.

Keywords: process-tracing, conditionality, institutionalism, Greece, e-prescription