Varying Costs to Change? Institutional Change in the Public Sector

• 成果类型: Article
• 署名作者: Gingrich, Jane
• 署名单位: University of Oxford
• 刊物名称: GOVERNANCE-AN INTERNATIONAL JOURNAL OF POLICY ADMINISTRATION AND INSTITUTIONS
• ISSN/ISSBN: 0952-1895
• DOI: 10.1111/gove.12076
• 发表日期: 2015
• 关键词: health-insurance; Path dependence; Managed care; welfare; POLITICS; POLICY; REFORM; DESIGN; state

摘要

Many scholars have argued that social programs are marked by a logic of increasing returns that makes change difficult. Yet over the past decades, reformers across industrialized countries have introduced substantial administrative reforms in these services, even as entitlement reform remains politically difficult. This paper explains these shifts by breaking apart the logic of increasing returns into three distinct costs to change: technical, political, and expectations. Decreases in a particular type of costs produce different logics of institutional changeback end, informal, and front endthat privilege the state, professionals or private, or political actors in distinct ways. I support these claims by reexamining three cases that were considered exemplars of stability but that ultimately had major entitlement reform: health care in the United Kingdom and United States and welfare programs in the United States. I show that even before radical reforms occurred, reformers introduced distinct logics of administrative change that underpinned later changes.