Vertical Alignment, Elite Power, and the Democratic Recess in the French Health Care System

Daniel Simonet

International Journal of Public Administration, 2018, vol. 41, issue 13, 1095-1106

Abstract: The article critically examines administrative restructuring of the French health care system. Despite calculated benefits of New Public Management (NPM) reforms, conflicts between values escalated. NPM-endorsed decentralization never took off in France. Instead, a re-concentration of health policy decisions benefited a Ministry-level welfare elite that sought to restore fiscal discipline rather than responsiveness to users. That process triggered a clash of culture with the medical profession and was at the expense of democratic participation. The role of citizens as reform overseers, although initially contained in the NPM doctrinal puzzle, never materialized. Key issues such as greater accountability and responsibility remain unresolved.

Date: 2018
References: Add references at CitEc
Citations:

Downloads: (external link)
http://hdl.handle.net/10.1080/01900692.2017.1318918 (text/html)
Access to full text is restricted to subscribers.

Related works:
This item may be available elsewhere in EconPapers: Search for items with the same title.

Export reference: BibTeX RIS (EndNote, ProCite, RefMan) HTML/Text

Persistent link: https://EconPapers.repec.org/RePEc:taf:lpadxx:v:41:y:2018:i:13:p:1095-1106

Ordering information: This journal article can be ordered from
http://www.tandfonline.com/pricing/journal/lpad20

DOI: 10.1080/01900692.2017.1318918

Access Statistics for this article

International Journal of Public Administration is currently edited by Ali Farazmand

More articles in International Journal of Public Administration from Taylor & Francis Journals
Bibliographic data for series maintained by Chris Longhurst ().