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Politics of policy learning: Evaluating an experiment on free pricing arrangements in Dutch dental care.

Martijn FelderHester van de BovenkampAntoinette de Bont
Published in: Evaluation (London, England : 1995) (2018)
In Dutch healthcare, new market mechanisms have been introduced on an experimental basis in an attempt to contain costs and improve quality. Informed by a constructivist approach, we demonstrate that such experiments are not neutral testing grounds. Drawing from semi-structured interviews and policy texts, we reconstruct an experiment on free pricing in dental care that turned into a critical example of market failure, influencing developments in other sectors. Our analysis, however, shows that (1) different market logics and (2) different experimental logics were reproduced simultaneously during the course of the experiment. We furthermore reveal how (3) evaluation and political life influenced which logics were reproduced and became taken as the lessons learned. We use these insights to discuss the role of evaluation in learning from policy experimentation and close with four questions that evaluators could ask to better understand what is learned from policy experiments, how, and why.
Keyphrases
  • healthcare
  • public health
  • health insurance
  • mental health
  • palliative care
  • quality improvement
  • oral health
  • affordable care act
  • single cell
  • gene expression
  • pain management