Bureaucratic Efficiency or Democratic Participation?
In 鈥淧ublic Perceptions of the Administrative Values Tradeoff: Bureaucratic and Democratic Ethos,鈥 (published this fall in Public Administration), SPA Distinguished Scholar in Residence Kenneth J. Meier and co-author Suyeon Jo (University of Arizona) examine public attitudes on the tension between bureaucratic efficiency and democratic values.
鈥淲ithin the American tradition, democratic participation has generally been seen as contributing to bureaucratic effectiveness, but generating tradeoffs relative to bureaucratic efficiency,鈥 said Meier.聽
Compared to many countries, he continued, U.S. bureaucracy is quite decentralized; even federally funded programs focus service delivery at the local level. The current model, established by the Department of Agriculture and echoed across a wide variety of other programs, holds that the hopes of citizens should guide program design and implementation.聽
鈥淭he thinking is that, to the degree that citizens think that their opinion will be listened to, it is worth their time and effort to participate,鈥 said Meier. 鈥淪o, opinions about the value of participation enhance its influence on bureaucratic effectiveness and, generally, program satisfaction.鈥
However, participation also poses costs, driven by the money, time, and other logistical considerations involved in creating opportunities for citizen feedback and mediating among conflicting views.聽
To understand how citizens view these tradeoffs, the authors conducted a vignette experiment in the context of U.S. nursing homes, with treatments designed to elicit views on the relative administrative values of effectiveness, efficiency, equity, and participation.聽
鈥淕enerally, citizens do not want to make tradeoffs,鈥 said Meier. 鈥淭hey prefer low taxes, high levels of service, and, generally, equal treatment. Unfortunately, with limited resources, there are inherent tradeoffs between equity and costs and between equity and effectiveness. The current study adds the element of participation . . . 聽to see if citizens 1) support greater participation opportunities, and 2) if they think having more participation opportunities conflicts with delivering effective services and saving costs.鈥
Their findings suggest that the public considers different values in assessing public organizations, and that they recognize the tradeoff between efficiency and participation. Further, citizens do value participation, less than effectiveness but more than equity or efficiency.聽
鈥淲hile citizens regard participation as important, they also recognize the conflicting relationship between participation and costs,鈥 said Jo. 鈥淪pecifically, our findings suggest that organizational efforts to save costs (i.e., improve efficiency) can improve citizens鈥 perceptions of program performance only when organizations offer fewer participation opportunities.鈥
While their results indicated a relative disinterest in equity, the authors advise against overinterpretation. The study鈥檚 context, elder care, is complicated by the fact that Medicaid, rather than Medicare, funds long-term care.
鈥淭he present case, elder care, deals with access,鈥 said Meier. 鈥淭he system is designed to deplete a person鈥檚 assets, so they have to go on Medicaid . . . Medicaid [also] permits poor individuals to access care. It might be that people think Medicaid handles [equity] and it is nothing to worry about.鈥澛
鈥淲hen there is a higher percentage of residents on Medicaid, [people] tend to think the organization is saving costs,鈥 added Jo. 鈥淥ne of our (unexpected) findings is that a significant and positive effect of a high level of equity (a higher percentage of residents on Medicaid) improved people鈥檚 perception of organizational efficiency, which supports this possibility.鈥
The study offers several practical implications for public managers. Recommendations include 1) increasing the number of public participation opportunities within performance management strategies, 2) communicating to citizens that participation and efficiency are not necessarily in conflict, and 3) providing citizens with different dimensions of performance information. 聽
鈥淭his conflict in values also plays out in general health care, social welfare, education, and a wide variety of other programs,鈥 said Meier. 鈥淚t is a fairly universal concern. We need to know more about how participation is valued in these other programs and if the public is willing to tolerate somewhat higher costs in exchange for participation opportunities.鈥