Post-NPM Reforms or Administrative Hybridization in the French Health Care System?

Abstract

New public management (NPM) provides an opportunity to analyze a reform trajectory that is influenced by country-specific institutional and social traditions. France adopted its own version of NPM, embracing some of its “traditional” elements such as quasi-markets and performance evaluation and rejecting others. NPM reforms in France pursued a re-centralization agenda rather than a disaggregation of public agencies. Outcomes were below expectations in core areas such as citizen participation and physician professional satisfaction. Subsequent health reforms indicate convergence toward a hybrid system rather than toward a post-NPM paradigm.