Publicness in times of market accountability: Lessons from a changing hospital industry in Germany

Abstract

Drawing on findings from a multiple case study on the changing hospital industry in Germany, this article sheds fresh light on the implications new public management-driven regulatory frameworks may have regarding the ‘publicness’ of public service settings. It is shown that, in the area under study, key ingredients of the settings’ traditional mission persist, as do expectations towards soci(et)al effectiveness of actual service delivery. However, this is paralleled by the rise of market accountability within and around these settings which undergirds the ‘privateness’ of public-service providing undertakings. Hydrid accountability relations coincide with a new organisational settlement which leads to a fuzzy configuration regarding the role of publicness. This is why a consistent reinvention of the latter is unlikely to occur under a regulatory framework featuring non-statutory and competitive public service provision.

Multidimensional Publicness and Collaboration for Community Benefits: The Case of U.S. Hospitals

“…Our results are in line with the literature, highlighting the importance of organizational forms for democratic governance design. While the New Public Management movement continues to advocate for privatization, it is important to keep in mind that privatization may have public value consequences: for public problems not essential to their bottom line, private organizations may be less motivated to step in (see also Bode ), especially when it requires cross‐sector collaboration to succeed…”

Paradoxical Internationalization: Regulatory Reforms in the Mexican Health‐Care System through the Lens of European Experience

“…As major health‐care policies use to be agreed with the aforementioned stakeholders, the steering arrangements relevant to health care are often referred to as being “corporatist.” Important decisions are taken by intermediate regulatory bodies entrusted with what is referred to as collective self‐administration (Bode ; Ettelt ). System coordination is also processed vertically, via funding contracts stipulating what providers receive for which kind of service and under what conditions.…”

“…The same applies to hospitals. Due to reforms enacted during the early 2000s, sickness funds pay uniform prices per inpatient treatment, with suppliers incurring the full economic risk related to the influx of users (Bode ). Providers compete for “cases,” for example, by cultivating informal connections to outpatient doctors in order to receive referrals.…”

“…The data on Germany is inferred from a recently completed research project on the changing governance of the country’s hospital sector (Bode ), and from previous studies on developments in healthcare administration (Bode ). The two projects embraced (altogether) 25 interviews involving 15 representatives of organizations involved in the regulation of the health‐care system (sickness funds, professional associations, hospital federations, and regional ministries).…”

Obstacles to regulating the private sector: The case of Korean long‐term care

“… 4 4 Meyer et al (2007) and Bridgen & Meyer (2009) indicate that Switzerland and the Netherlands have realized social rights and social justice in their old age income security system even though they have large private pensions. Also, even though the proportion of private LTC providers in Denmark has been high, they achieved good protection for the fragile old (Bode 2019). …”