Public organizations, stakeholders and the construction of publicness. Claims and defence of authority in public action

This article seeks to highlight the conditions in which organizations with different levels of 'publicness' interact in the framework of policy-making. In France, decision making and implementation is shared among public, semi-public and private organizations. The specific responsibility and influence of public organizations within institutional collective action however is a source of ambiguity. It becomes therefore a matter of political authority for public organizations to invest in the structuring of public problems and policies. The case analysed here shows that the publicness of implemented policies is a construction which stakeholders may try to influence. Responses by public organizations show that publicness does not only relate to the plurality of organizational forms but also to the existence of a form of hierarchy within systems of governance themselves.     

The debate over the U.S. government's role in health care financing:"deja vu,all over again"

Yogi Berra's famous quote captures the continuing debate over the legitimate role of the U.S. government in health care financing. The issues of individual choice, equity of access, and concern about income security are just as unresolved today as they were in the early twentieth century. Until we engage in an explicit national debate on these issues and come to a national consensus on the human and political values underlying our current health care situation, a “solution” to the health care financing problems will never be found. This article discusses the history of the issue of government's involvement in health care financing, American ambivalence about government regulation, and the role of American business as a major health care insurer.