000			01344nam a2200181 4500
999			_c509500 _d509500
008			190510b ||||| |||| 00| 0 eng d
100			_aSimonet, Daniel _95394
245			_aVertical alignment, elite power, and the democratic recess in the French health care system
260			_c2018
300			_ap.1095-1106.
520			_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.
650			_aAdministrative reforms _95395
650			_aPublic administration _95396
650			_aNew Public Management _96130
773			_aInternational Journal of Public Administration
906			_aHealth care - France
942			_2ddc _cAR