Privatizing New York City's public hospitals: The politics of policymaking.
Item
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Title
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Privatizing New York City's public hospitals: The politics of policymaking.
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Identifier
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AAI9830741
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identifier
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9830741
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Creator
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Mitchell, Maria K.
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Contributor
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Adviser: John Mollenkopf
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Date
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1998
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Language
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English
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Publisher
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City University of New York.
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Subject
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Political Science, General | Health Sciences, Health Care Management
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Abstract
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This is a case study of New York City Mayor Rudolph W. Giuliani's initiative to privatize municipal hospitals. The study analyzes how Giuliani's belief in reinventing government brought him to the conclusion that privatization was a solution to the long standing problems of the New York City Health and Hospitals Corporation (HHC), the largest municipal hospital system in the country. The research analyzes in depth the factors that influenced the Giuliani administration's decision to seek privatization of the municipal hospitals in New York City. It also examines the course of events that effected this initiative. The study also challenges the thesis of Sayre and Kaufman (1960), and others, that change in New York City is impossible. Finally, this case study examines the relationship of the public and private sector during the three-year effort to privatize the public hospitals. John Kingdon's model of policymaking is used as a framework for presentation of the research (1995).;This research supports the literature that finds that competition induced by privatization is a fundamental and positive element of privatization. This study also confirms the findings in the literature that public accountability is paramount to the success of privatization and that the Kingdon and Birkland theories that crises and focusing events help bring and maintain policy items on the agenda is accurate. There is a need to articulate clear goals and expected outcomes at the outset of privatization. Because privatization is often driven by ideology, it disrupts other privatization initiatives in that it is easy to misperceive intentions or purposefully distort the goals of the advocates of a particular privatization initiative. There is a need to discuss and evaluate privatization on more than a cost-benefit basis. This study adds to the privatization literature, and provides a guide to policy makers in outlining the need for assessment of the political environment, strategy development and strategy implementation during privatization. It is demonstrated here that through innovative leadership, it is possible to make positive changes in New York City's bureaucracies.
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Type
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dissertation
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Source
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PQT Legacy CUNY.xlsx
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degree
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Ph.D.
