{"title":"Seeking policy solutions in a complex system: experimentalist governance in China's healthcare reform.","authors":"Alex Jingwei He, Yumeng Fan, Rui Su","doi":"10.1007/s11077-022-09482-2","DOIUrl":null,"url":null,"abstract":"<p><p>The proliferation of \"wicked\" policy problems in complex systems requires an experimental approach of problem-solving. Experimentalist governance offers a conducive framework through which to seek policy solutions amidst high levels of complexity in a multilevel governance structure. This study conceptualizes four distinctive experimental modalities based on varying levels of technical complexity and interest complexity, both of which represent salient constraints for policy reforms in a complex system, the health sector in particular. <i>Trail-blazing pilots</i>, <i>crowdsourcing pilots</i>, <i>managed pilots</i>, and <i>road-testing pilots</i> are all associated with distinct mechanisms of experimentation in a multilevel governance structure. Through four illustrative cases from China's massive experimental program of public hospital reform, this study demonstrates how experimentalist governance seeks policy solutions in the health sector. Should governance arrangements, policy capacity, pragmatism, and informational devices become aligned in a conducive way, experimentalist governance can play an instrumental role in seeking solutions for difficult problems in a complex policy system. A governance structure capable of policy learning and adaptive management is the key.</p>","PeriodicalId":51433,"journal":{"name":"Policy Sciences","volume":null,"pages":null},"PeriodicalIF":3.8000,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9676842/pdf/","citationCount":"2","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Policy Sciences","FirstCategoryId":"91","ListUrlMain":"https://doi.org/10.1007/s11077-022-09482-2","RegionNum":3,"RegionCategory":"管理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2022/11/19 0:00:00","PubModel":"Epub","JCR":"Q1","JCRName":"PUBLIC ADMINISTRATION","Score":null,"Total":0}
引用次数: 2
Abstract
The proliferation of "wicked" policy problems in complex systems requires an experimental approach of problem-solving. Experimentalist governance offers a conducive framework through which to seek policy solutions amidst high levels of complexity in a multilevel governance structure. This study conceptualizes four distinctive experimental modalities based on varying levels of technical complexity and interest complexity, both of which represent salient constraints for policy reforms in a complex system, the health sector in particular. Trail-blazing pilots, crowdsourcing pilots, managed pilots, and road-testing pilots are all associated with distinct mechanisms of experimentation in a multilevel governance structure. Through four illustrative cases from China's massive experimental program of public hospital reform, this study demonstrates how experimentalist governance seeks policy solutions in the health sector. Should governance arrangements, policy capacity, pragmatism, and informational devices become aligned in a conducive way, experimentalist governance can play an instrumental role in seeking solutions for difficult problems in a complex policy system. A governance structure capable of policy learning and adaptive management is the key.
期刊介绍:
The policy sciences are distinctive within the policy movement in that they embrace the scholarly traditions innovated and elaborated by Harold D. Lasswell and Myres S. McDougal. Within these pages we provide space for approaches that are problem-oriented, contextual, and multi-method in orientation. There are many other journals in which authors can take top-down, deductive, and large-sample approach or adopt a primarily theoretical focus. Policy Sciences encourages systematic and empirical investigations in which problems are clearly identified from a practical and theoretical perspective, are well situated in the extant literature, and are investigated utilizing methodologies compatible with contextual, as opposed to reductionist, understandings. We tend not to publish pieces that are solely theoretical, but favor works in which the applied policy lessons are clearly articulated. Policy Sciences favors, but does not publish exclusively, works that either explicitly or implicitly utilize the policy sciences framework. The policy sciences can be applied to articles with greater or lesser intensity to accommodate the focus of an author’s work. At the minimum, this means taking a problem oriented, multi-method or contextual approach. At the fullest expression, it may mean leveraging central theory or explicitly applying aspects of the framework, which is comprised of three principal dimensions: (1) social process, which is mapped in terms of participants, perspectives, situations, base values, strategies, outcomes and effects, with values (power, wealth, enlightenment, skill, rectitude, respect, well-being, and affection) being the key elements in understanding participants’ behaviors and interactions; (2) decision process, which is mapped in terms of seven functions—intelligence, promotion, prescription, invocation, application, termination, and appraisal; and (3) problem orientation, which comprises the intellectual tasks of clarifying goals, describing trends, analyzing conditions, projecting developments, and inventing, evaluating, and selecting alternatives. There is a more extensive core literature that also applies and can be visited at the policy sciences website: http://www.policysciences.org/classicworks.cfm. In addition to articles that explicitly utilize the policy sciences framework, Policy Sciences has a long tradition of publishing papers that draw on various aspects of that framework and its central theory as well as high quality conceptual pieces that address key challenges, opportunities, or approaches in ways congruent with the perspective that this journal strives to maintain and extend.Officially cited as: Policy Sci