Public Accountability and Health Care Governance : Public Management Reforms Between Austerity and Democracy

This book deals with the critical empirical void created by the speed at which healthcare restructuring has taken place in Europe. Chapters explore the political uncertainty and budgetary pressures which have led governments increasingly to turn to New Public Management (NPM)-style reforms to attempt to balance the financial viability of public health structures, with democratic imperatives to maintain socially just outcomes. The authors of this volume consider how governments have therefore shifted identities from principal care providers to contractual monitors, setting targets increasingly directed toward third-party managers in quasi-markets and the private sector. Drawing upon extensive data from Germany, Norway, the Netherlands, and Israel, the contributions explore the often unexpected policy outputs and outcomes engendered by such reforms. Front Matter....Pages i-xi Public Management Reforms and Their Impact on Democratic Processes....Pages 1-11 German Healthcare in Transition: Global Pressures, Governance and Public Wellbeing....Pages 13-35 Hospital Planning in a Competitive Arena: Sustaining or Suspending Market Forces?....Pages 37-64 Marketization and Accountability: Lessons from the Reforming Norwegian Healthcare System....Pages 65-89 From Demigods in White to Normal Employees: Employment Relations and New Incentive Structures in German Hospitals....Pages 91-114 Accountability in Multilevel Health Care Services: The Case of Norway....Pages 115-146 Organ Transplant Policies and Cultural Worldviews....Pages 147-163 From “Major Decisions” to “Everyday Life”: Direct Accountability to Clients....Pages 165-192 Accountability and Shared Measurement in Health Care: Examples from Israel....Pages 193-215 Back Matter....Pages 217-226 This work deals with the critical empirical void created by the speed at which healthcare restructuring has taken place in Europe. Chapters explore the political uncertainty and budgetary pressures which have led governments increasingly to turn to New Public Management (NPM)-style reforms to attempt to balance the financial viability of public health structures, with democratic imperatives to maintain socially just outcomes. The authors of this volume consider how governments have therefore shifted identities from principal care providers to contractual monitors, setting targets increasingly directed toward third-party managers in quasi-markets and the private sector