01344nam a2200181 4500 509500 509500 190510b ||||| |||| 00| 0 eng d Simonet, Daniel 5394 Vertical alignment, elite power, and the democratic recess in the French health care system 2018 p.1095-1106. 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. - Reproduced. Administrative reforms 5395 Public administration 5396 New Public Management 6130 International Journal of Public Administration Health care - France ddc AR 0 0 ddc 0 0 383440 IIPA IIPA 2019-05-10 41(13), Oct, 2018: p.1095-1106. AR119669 2019-05-10 AR