In Governing the Hallow State, Milward and Provan (2000) describe the hallow state is a metaphor for the increasing use of third parties to provide public services on behalf of the state. This paper is a summation of a decade of theoretical development and empirical findings from their research on the dimensions and impact of the hollow state in the domain of health and human service contracting. Past research focused on how effectual various types of mechanisms, structures, and incentives are at promoting the effectiveness of contracted services. The current aim is to bring together what the authors have learned and suggestions for new future research. Milward and Provan address the normative question, “what effects does government contracting …show more content…
Milward and Provan (2000) note there is little research on how to manage decentralized services effectively, and limited evidence that community coalitions build social capital, however, the role of governing the hallow state is nonetheless to manage hierarchies of networks. Their concern is that networks are less stable than one agency, thus they argue for a new approach to governing networks where the need for cooperation and coordination are high. They propose a principal-agency model for effective network …show more content…
While principal-agent theory may run counter to public sector service delivery in health and human services, Milward an Provan assert that “integration through public authorities that concentrate local funding in one set of hands and arrange for the provision of community-based services by a network of providers will be more effective than other alternatives” (p. 365). For example, stability promotes cooperation, and by giving the principal time to learn to govern the system, including the right to exclude other agencies, the probability of cooperation increases as it becomes less rational to behave in an opportunistic fashion. In addition, a key mechanism to effective jointly produced service was direct fiscal control by the state. Other factors of effective network governance include: principle agency should produce some services, not only govern; continuity of organizations in the network (infrequent bidding) ensures a long-term perspective; and resources are important when combined with these other elements (see pages 375 and 376 for a complete summary). It should be noted, however, that only leaving ways to monitor and negotiate contracts (authority) does not ensure accountability. In addition to these mechanisms and structures, what shouldn’t change in a network is the
Municipal control or an alternative delivery method? This is the question that has intrigued all levels of local government and created intense debates between taxpayers across municipalities. The services that municipalities provide are often vital to the existence of a local area. The issues of accountability, cost savings, quality of service and democracy often arise when choosing the best options to deliver services to a municipal area. In recent years the concepts of privatization, alternative service delivery and public-private partnerships are often promoted as ways cut down on overburdened annual city budgets and promote a higher quality of service to citizens. Municipalities have historically always provided basic services such as fire protection, water purification/treatment and recreational facilities. However, would private companies or another municipality be able to better deliver the same services more efficiently or at a lower cost? The city or town often provides a political grass roots approach to most local problems. Municipalities are better positioned and have a wider scope to provide services to their constituents in order to ensure quality of service that does not erode accountability and transparency, or drive the municipality deeper into debt.
Healthcare in the United States is an extremely often discussed topic on whether it is morally a right or just a charity to those who cannot afford it. Plenty claim that health care is too expensive and not affordable so they demand aid from the government. On the other hand, the rest presume that the state is not morally accountable to take this type of action, since not every citizen and human being is equally eligible to receive the same healthcare.
Vangen, S., & Huxham, C. K. (2012). The tangled web: Unraveling the principle of common goals in collaborations. Journal of public administration research & theory, 22(4), 731-760.
Davidson, Stephen M. Still Broken: Understanding the U.S. Health Care System. Stanford, CA: Stanford Business, 2010. Print.
“I brought you guys here for better”. These are the words my mother told me many times as a boy and again not long ago. My mother has always pushed me in my education, and I finally realized that my junior year of high school. My grades in everything were outstanding this year, but I was still missing out on something. I was still not very involved in school. One day an individual from the American Legion came to our school to talk to all the juniors. He told us about an event that happens every year and in every state. It was a prestigious event to be accepted to. Having no real involvement in anything, I did not think for a second that I would be accepted, but, regardless, I applied, and two months later I received a call from that same man who told me I had been accepted. I was a big reluctant and indecisive about going because, aside from the fun and games, there was government learning and marching involved. I decided to go, and will never regret that decision. The experience there changed my views in so many ways. I met so many new people, greatly strengthened my skills in leadership, and I realized I had the potential to not only dream about my goals, but to live them as well.
Barton, P.L. (2010). Understanding the U.S. health services system. (4th ed). Chicago, IL: Health Administration Press.
The state is responsible for the overall regulatory, supervisory and fiscal functions as well as for quality monitoring and planning of the distribution of medical specialties at the hospital level (Schäfer et al., 2010). The 5 regions are responsible for hospitals and for self-employed health care professionals, whereas the municipalities are responsible for disease prevention and health promotion rel...
A country’s health care system refers to all the institutions, programs, personnel, procedures, and the resources that are used to meet the health needs of its population. Health care systems vary from one country to another, depending on government policies and the health needs of the population. Besides, health care programs are flexible in the sense that they are tailored to meet health needs as they arise. Among the stakeholders in the formulation of a country’s health care system are governments, religious groups, non-governmental organizations, charity organizations, trade/labor unions, and interested individuals (Duckett, 2008). These entities formulate, implement, evaluate, and reform health services according to the needs of the sections of the population they target.
Shi, L. & Singh, D. A. (2010). Delivering Health Care in America: A System Approach 5th ed. Baltimore, Maryland: Jones & Bartlet
It was a long and hard road to find my spirituality. Long ago I was an atheist, but after many months, even years of searching and thinking I began to find my own sense of religion. The steps cannot be done in one night. Not even in one week. They need constant revision and repetition. Sooner or later you will find your own spirituality.
...r pillars of public administration are equally important in the process of public administration and complement one another in the provision of quality public service. When public administrators have economy in mind they focus on the best combination of available resources to provide optimum public service. To ensure that public service is not limited to only a section of the public, the issue of equity is taken into consideration so that public interest is realized. Efficiency and effectiveness additionally go hand in hand in ensuring that allocated resources are used in the best possible manner to attain set goals. Thus whereas the first three public administration pillars – Economy, efficiency and effectiveness are concerned with how public service is provided the fourth and most recent addition (Equity) concerns with for whom public service is provided.
On a large scale, governance describes methods a governing body uses to ensure its citizens follow established protocol. At the macro level, there is a loosely coupled organizations structure that supervises and maintains respons...
The improvement of health, enforcing policies, and monitoring comes from interrelationships between governmental and non-governmental entities. Since the 21st century the apparent need for an improved public health infrastructure has been a recurring topic on the state, local, and national level. In 2010 the Affordable Care Act authorized numerous clinical health reforms, a big step towards providers being accountable. {ACOs} Accountable care organizations are conducting health assessments and reporting metrics to payers. According to Magnuson and Fu, Jr., “Public health agencies must, in turn, evolve from being the only entities capable of assessing and monitoring population health to strategic and enabling partners involved in population health practice” (2014). A sense of involvement and shared work load is needed to help shift the challenges public health officials face. Public health officials promote and protect the community. With the involvement of other organizations more polices can be enforced and created to improve population
This essay discusses the radical transformation of the principles and foundations of public administration from traditional to New Public Management. Firstly the essay will attempt to define the key terms of traditional public administration and the doctrine of New Public Management. Rabin J. (2003) explains that New Public Management embodies “a process in public administration that uses information and experiences obtained in business management and other disciplines to improve efficiency, usefulness and general operation of public services in contemporary bureaucracies.“Traditional Public Administration progresses from governmental contributions, with services perceived by the bureaucracy.
The lack of service delivery is a vital subject that is tackled by countless residents and government officials. Thus, distinct methods are needed to safeguard that services are delivered below the leadership of local government. The purpose if this essay is to converse about the reasons why governments commence on Alternative service delivery mechanisms. This will be accomplished by bestowing definitions of precise concepts by also considering technological improvements as Alternative service delivery methods. Furthermore, this essay will recognize alongside suitable examples, the acts played by voluntary associations and private contractors in advancing competent and effectual ability to deliver services.