01467nam a2200193   4500999001900000008004100019100002600060245009600086260000900182300001700191520076900208650003300977650003201010650003201042773005101074906002501125942001201150952011101162  c509500d509500190510b           ||||| |||| 00| 0 eng d  aSimonet, Daniel95394  aVertical alignment, elite power, and the democratic recess in the French health care system  c2018  ap.1095-1106.  aThe 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.  aAdministrative reforms95395  aPublic administration95396  aNew Public Management96130  aInternational Journal of Public Administration  aHealth care - France  2ddccAR  00102ddc40709383440aIIPAbIIPAd2019-05-10h41(13), Oct, 2018: p.1095-1106.pAR119669r2019-05-10yAR