Governing Health Care in an Imperfect World: Hierarchy, Markets and Networks in China and Thailand

Abstract

“Anything but the government” has been a popular sentiment in public policy circles for at least two decades. Initially, the sentiment favoured transitions from governments to market-based governance regimes but the tilt has shifted towards transition from governments to network governance in recent years (for discussion of the key relevant concepts, see Lowndes and Skelcher 1998). Much discussion on the subject suggests that such shifts from hierarchical to non-hierarchical governance are both unavoidable and desirable for addressing contemporary complex multi-actor problems which more traditional government-based arrangements find difficult to “steer” (Weber et al. 2011; Lange et al. 2013). Many proponents, for example, claim “network governance” or “collaborative governance” combines the best of both government-and market-based arrangements by bringing together key public and private actors in a policy sector in a constructive and inexpensive way (Rhodes 1997). This claim is no more than an article of faith, however, as there is little evidence supporting it and a lot of evidence contradicting this thesis (see Kj-r 2004; van Kersbergen and van Waarden 2004; Adger and Jordan 2009; Howlett et al. 2009, Hysing 2009). It is entirely possible that network governance combines and indeed compounds the ill-effects of both governments and markets rather than improves upon them and this is a subject area requiring further empirical examination.