Abstract
How is policy change possible if policy entrepreneurs’ cognition, rationality and identity are conditioned by the very policy institutions they wish to change? To solve this paradox of embedded agency, we must avoid either voluntarism that inflates the role of actors to change policies as by existing policy entrepreneurship applications, or determinism whereby policy changes are decided by contextual forces. Instead, drawing on institutional theory, critical realism sees structures, institutions, and actions that constitute policy dynamics as existing in separate yet intertwined reality domains: structures (e.g., social relationships), and institutions (e.g., formal rules and norms such as institutional logics) in the Real domain, enable and constrain policy actors’ navigation of their social environments; the Actual domain represents the level at which events (actions) happen, as these actors constantly interpret varied institutions to adjust their structurally embedded actions when pursuing policy changes that can be observed in the Empirical domain. Put differently, structures and institutions are mechanisms in the Real domain that affect individual practices and events in the Actual domain, and only some of these events are realized in the Empirical domain as policy changes. We empirically illustrate this critical realist approach with a Chinese example on health care reform.
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References
Alvesson, M., & Spicer, A. (2019). Neo-institutional theory and organization studies: A mid-life crisis? Organization Studies, 40(2), 199–218.
Archer, M. (1995). Realist social theory: The morphogenetic approach. Cambridge University Press.
Archer, M. (1996). Culture and agency. Cambridge University Press.
Archer, M. (2003). Structure, agency, and the internal conversation. Cambridge University Press.
Arnold, G., et al. (2017). Social networks and policy entrepreneurship. Policy Studies Journal, 45(3), 414–441.
Arnold, G. (2022). A threat-centered theory of policy entrepreneurship. Policy Sciences, 55, 23–45.
Bakir, C. (2009). Policy entrepreneurship and institutional change. Governance, 22(4), 571–598.
Bakir, C. (2013). Bank behaviour and resilience. Palgrave Macmillan.
Bakir, C. (2017). How can interactions among interdependent structures, institutions, and agents inform financial stability? Policy Sciences, 50, 217–239.
Bakir, C., et al. (2021). Why does the combination of policy entrepreneur and institutional entrepreneur roles matter for the institutionalization of policy ideas? Policy Sciences, 54, 397–422.
Bakir, C., & Gunduz, K. A. (2017). When, why and how institutional change takes place. Policy and Society, 36(4), 479–503.
Bakir, C., & Gunduz, K. A. (2020). The importance of policy entrepreneurs in developing countries: A systematic review. Public Administration and Development, 40(1), 11–34.
Bakir, C., & Jarvis, D. (2017). Contextualising the context in policy entrepreneurship and institutional change. Policy and Society, 36(4), 465–478.
Balla, S. (2001). Interstate professional associations and the diffusion of policy innovations. American Politics Research, 29, 221–245.
Béland, D. (2016). Kingdon reconsidered: Ideas, interests and institutions in comparative policy analysis. Journal of Comparative Policy Analysis: Research and Practice, 18(3), 228–242.
Béland, D., & Cox, H. (2016). Ideas as coalition magnets: Coalition building, policy entrepreneurs, and power relations. European Journal of Public Policy, 23, 428–445.
Béland, D., & Howlett, M. (2016). How solutions chase problems. Governance, 29, 393–409.
Bhaskar, R. (1978). A reality theory of science (2nd ed.). Harvester Press.
Bhaskar, R. (1998). The possibility of naturalism. Routledge.
Bjerregaard, T., & Jonasson, C. (2014). Managing unstable institutional contradictions. Organization Studies, 35, 1507–1536.
Blumenthal, D., & Hsiao, W. (2005). Privatization and its discontents. New England Journal of Medicine, 353, 1165–1170.
Cairney, P. (2018). Three habits of successful policy entrepreneurs. Policy and Politics, 46(2), 199–215.
Capano, G. (2009). Understanding policy change as an epistemological and theoretical problem. Journal of Comparative Policy Analysis: Research and Practice, 11(1), 7–31.
Chen, J., et al. (2013). Medical professionalism among clinical physicians in two tertiary hospitals, China. Social Science & Medicine, 96, 290–296.
Clegg, S. (2010). The state, power, and agency. Journal of Management Inquiry, 19(1), 4–13.
Collier, A. (2004). In defence of objectivity. Routledge.
Delbridge, R., & Edwards, T. (2013). Inhabiting institutions: Critical realist refinements to understanding institutional complexity and change. Organization Studies, 34(7), 927–947.
DiMaggio, P. (1997). Culture and cognition. Annual Review of Sociology, 23, 263–287.
Dong, Z., & Phillips, M. (2008). Evolution of China’s health-care system. Lancet, 372, 1715–1716.
Durkheim, E. (1984). The Division of Labour in Society (trans. The French edition of 1893 by W. D. Halls with an introduction by Lewis Coser). Macmillan.
Elmelund-Præstekær, C., & Klitgaard, M. (2012). Policy or institution? The political choice of retrenchment strategy. Journal of European Public Policy, 19(7), 1089–1107.
Fine, G., & Hallett, T. (2014). Group cultures and the everyday life of organizations. Organization Studies, 35, 1773–1792.
Fischer, F. (1998). Beyond empiricism: Policy inquiry in the postpositivist perspective. Policy Studies Journal, 26(1), 129–146.
Fleetwood, S. (2005). Ontology in organization and management studies. Organization, 12(2), 197–222.
Fleetwood, S. (2008). Institutions and social structures. Journal for the Theory of Social Behaviour, 38, 241–265.
Fleetwood, S. (2021). Re-visiting rules and norms. Review of Social Economy, 79(4), 607–635.
Frisch-Aviram, N., et al. (2019). Entrepreneurship in the policy process. Public Administration Review, 80(2), 88–197.
Fu, H., et al. (2017). An evaluation of systemic reforms of public hospitals in China. Health Policy and Planning, 32, 1135–1145.
Gawer, A., & Phillips, N. (2013). Institutional work as logics shift. Organization Studies, 34, 1035–1071.
Geertz, C. (1973). The interpretation of cultures. Basic Books.
Greenwood, R., et al. (2011). Institutional complexity and organizational responses. The Academy of Management Annals, 5(1), 317–371.
He, A. (2018). Maneuvering within a fragmented bureaucracy: Policy entrepreneurship in China’s local healthcare reform. The China Quarterly, 236, 1088–1110.
Hodgson, G. (2006). What are institutions. Journal of Economic Issues, 40(1), 1–25.
Holm, P. (1995). The dynamics of institutionalization. Administrative Science Quarterly, 40, 398–422.
Hsiao, W. (2007). The political economy of Chinese health reform. Health Economics, Policy and Law, 2, 241–249.
Hu, Z., et al. (2020). Reluctant policy innovation through profit concession and informality tolerance. Public Administration and Development, 40(1), 65–75.
Jarvis, D., & He, A. (2020). Policy entrepreneurship and intuitional change: Who, how, and why? Public Administration and Development, 40(1), 3–10.
Jones, M., et al. (2016). A river runs through it: A multiple streams meta-review. Policy Studies Journal, 44(1), 13–36.
Kingdon, J. (1984). Agendas, alternatives, and public policies. Boston: Little Brown.
Kodeih, F., & Greenwood, R. (2014). Responding to institutional complexity. Organization Studies, 35, 7–39.
Laffan, B. (1997). From policy entrepreneur to policy manager. Journal of European Public Policy, 4(3), 422–438.
Leca, B., & Naccache, P. (2006). A critical realist approach to institutional entrepreneurship. Organization, 13, 627–651.
Lounsbury, M., & Crumley, E. (2007). New practice creation: An institutional perspective on innovation. Organization Studies, 28, 993–1012.
McPherson, C., & Sauder, M. (2013). Logics in action. Administrative Science Quarterly, 58(2), 165–196.
Meyer, R., et al. (2014). Of bureaucrats and passionate public managers: Institutional logics, executive identities, and public service motivation. Public Administration, 92(4), 861–885.
Mintrom, M. (2000). Policy entrepreneurs and school choice. Washington, DC: Georgetown University Press.
Mintrom, M., et al. (2020). Policy entrepreneurship in Asia. Journal of Asian Public Policy, 13(1), 1–17.
Mintrom, M., & Norman, P. (2009). Policy entrepreneurship and policy change. The Policy Studies Journal, 37(4), 649–667.
Mintrom, M., & Vergari, S. (1996). Advocacy coalitions, policy entrepreneurs, and policy change. Policy Studies Journal, 24, 420–434.
North, D. (1994). Economic performance through time. American Economic Review, 84(3), 359–367.
Parker, J., et al. (2003). Social theory: A basic tool kit. Palgrave Macmillan.
Petridou, E., et al. (2021). Policy entrepreneurs in public administration: A social network analysis. Politics & Policy, 49(2), 414–445.
Petridou, E., & Mintrom, M. (2021). A research agenda for the study of policy entrepreneurs. Policy Studies Journal, 49, 943–967.
Popper, K. (1990). A world of propensities. Thoemmes Antiquarian Books.
Porpora, D. (1989). Four concepts of social structure. Journal for the Theory of Social Behaviour, 19, 195–211.
Porpora, D. (2015). Reconstructing sociology: The critical realist approach. Cambridge University Press.
Ramesh, M., et al. (2014). Health governance and healthcare reforms in China. Health Policy and Planning, 29(6), 663–672.
Rao, H., et al. (2003). Institutional change in Toque Ville. American Journal of Sociology, 108(4), 795–843.
Roberts, N., & King, P. (1991). Policy entrepreneurs: Their activity structure and function in the policy process. Journal of Public Administration Research and Theory, 1(2), 147–175.
Runde, J. (1996). On popper, probabilities, and propensities. Review of Social Economy, 54, 465–485.
Scott, W. (1995). Institutions and organizations. SAGE Publications.
Seo, M., & Creed, W. (2002). Institutional contradictions, praxis, and institutional change: A dialectical perspective. The Academy of Management Review, 27(2), 222–248.
Shearer, J., et al. (2016). Why do policies change? Institutions, interests, ideas, and networks in three cases of policy reform. Health Policy and Planning, 31, 1200–1211.
Shipan, C., & Volden, C. (2006). Bottom-up federalism. American Journal of Political Science, 50, 825–843.
Smith, C. (2011). What is a person. Chicago: University of Chicago Press.
Swidler, A. (1986). Culture in action. American Sociological Review, 51(2), 273–286.
Thornton, P., et al. (2012). The institutional logics perspective. Oxford University Press.
Townley, B. (1997). The institutional logic of performance appraisal. Organization Studies, 18(2), 261–285.
Tu, W., et al. (2019). The Sanming three-in-one model. Journal of American Geriatrics Society, 67, 2213–2215.
Wang, L., et al. (2019). The development and reform of public health in China from 1949 to 2019. Global Health. https://doi.org/10.1186/s12992-019-0486-6
Wang, M., et al. (2021). From grace to violence: Stigmatizing the medical profession in China. Academy of Management Journal, 64, 1842–1872.
Weissert, C. (1991). Policy entrepreneurs, policy opportunists, and legislative effectiveness. American Politics Research, 19, 262–274.
Wohlgemut, M. (2000). Political entrepreneurship and bidding for political monopoly. Journal of Evolutionary Economics, 10, 273–295.
Wu, D., et al. (2017). Challenges to healthcare reform in China. Health Policy and Planning, 32, 1241–1247.
Yang, Y. (2021). Beyond Weber and Kafka: Conceptualizing a critical realist model of bureaucracy. Administration & Society, 54(3), 500–521.
Yip, W., et al. (2012). Appraisal of China’s huge and health care reforms. Lancet, 379, 833–842.
Yip, W., & Hsiao, W. (2014). Harnessing the privatization of China’s fragmented health-care delivery. Lancet, 384, 805–818.
Zahariadis, N. (2016). Delphic oracles: Ambiguity, institutions, and multiple streams. Policy Sciences, 49(1), 3–12.
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This work was supported by the Social Science Fund of Beijing Municipality [Grant Number: 18ZGC012] and the Institute of Public Governance, Peking University [Grant Number: YBXM202207].
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Yang, Y. The fable of policy entrepreneurship? Understanding policy change as an ontological problem with critical realism and institutional theory. Policy Sci 55, 573–591 (2022). https://doi.org/10.1007/s11077-022-09463-5
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DOI: https://doi.org/10.1007/s11077-022-09463-5