Volume 13, Number 1, Spring 2010

CONTENTS
REGULAR ARTICLES


Competing Forces in Outpatient Healthcare Delivery: Theory and Empirics ........................................................................................................ 1
L. V. Fulton


SYMPOSIUM


Symposium on Antiessentialism and Public Administration: Issues and "Isms" .............................................................................................. 34
H. T. Miller and A. Sapat

Symposium Introduction ................................................................................................................................................................................................. 35
H. T. Miller and A. Sapat

Reconciling Postmodern Public Administration and Constitutionalism: Some Reflections on the Ideas of Stuart Hampshire ............... 39
M. W. Spicer

Anti-Essentialism in Multicultural Societies: Facilitating Multicultural Discourse through Tolerance of Cultural Pluralism ....................... 60
D. M. Staniševski

"Democracies' Guardian Genius": Pragmatism and Liberal Discourse in Public Policy .................................................................................. 87
H. J. Hacker

The New Pragmatism, Anti-Essentialism, and What Is the Univeral: It's the Situation All the Way Down ................................................... 111
C. F. Abel

ABSTRACT. A well-known scientist once gave a public lecture on astronomy.
He described how the earth orbits around the sun and how the sun, in turn,
orbits around the center of a vast collection of stars called our galaxy. At the
end of the lecture, a little old lady at the back of the room got up and said:
"What you have told us is rubbish. The world is really a flat plate supported
on the back of a giant tortoise." The scientist gave a superior smile before
replying, "What is the tortoise standing on?" "You're very clever, young man,"
said the old lady. "But it's turtles all the way down!"

ABSTRACT. Drawing on the ideas of Stuart Hampshire, this paper argues that
American constitutionalism, thought of as a set of practices for resolving
conflict, may be especially helpful in the postmodern condition because it
encourages the resolution of conflict among different cultural conceptions of
the good by practices of adversarial argument and procedural justice, rather
than simply by force and violence. Consequently, a constitutional approach
to American public administration has merit in directing our attention
towards our particular practices for resolving value conflict. However, a
constitutional approach cannot provide universal standards for the fair
resolution of conflict. Also, any attempt to legitimate public administration in
our constitutional practices is always potentially problematic because such
practices, themselves, are always contestable.

ABSTRACT. While liberals agree that the best society is one that supports
the equal exercise of personal liberty, there is little agreement among them
on what policies best achieve this end. Conflicts within liberalism over the
place of socially derived goals vis-à-vis personal liberty and autonomy create
tension and skew public discourse on policy alternatives. In this article, I
characterize the debate among dominant strands of liberal ideology and
consider the effort of Charles Taylor to resolve these tensions. Finding his
resolution unsatisfying, I explore the alternative conception offered by
American pragmatism. I argue that liberal theories fail because they fall prey
to the problem of principles–they attempt to justify axiomatic thinking rather
than perpetuate society and culture. Pragmatism provides a justification for
liberal public discourse as the best mechanism for constructing, evaluating
and revising policies that support cultural adaptation to social, economic
and technological contingencies.

ABSTRACT. Approaching anti-essentialism from the perspective of multiculturalism
this article reexamines the value of tolerance in dealing with
inter-cultural conflicts and in facilitation of multicultural discourses. It
asserts that tolerance can be a potentially useful practice in specific local
contexts, but it is not an ideal in itself. The article questions the role of public
administration in building tolerance for cultural diversity and argues that
providing visible forms of public recognition of cultural practices could be
one possible role for government agencies.

ABSTRACT. This study tests the effects of incomplete institutionalization in
outpatient healthcare delivery settings on the quality and quantity of
services provided after controlling for technical and agency factors. One
dimension of quality (provider-patient contact time) and one dimension of
quantity (number of services provided) were examined using the National
Ambulatory Medical Care Survey for the year 2000. Regression models
capture 27.8% and 36.4% of the variance in these respective dimensions
(p<.001). The results reaffirm that uncertainty breeds variation and that
ownership differences matter. From a management perspective, the
regression model associated with provider-contact time has added utility in
that a priori knowledge of certain variables might be used as decision
support for provider (and service) scheduling.

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