Chapter 11: Putting It All Together

Osborne and Gaebler suggest that the ten principles of government, as outlined in the ten chapters of the book, can serve as a checklist to unleash new ways of thinking and acting for any public organization. To test the list as an analytical tool, they take three of the most challenging public problems faced by American society and apply their principles of entrepreneurial government.

Health Care is the first problem tackled. The authors cite many problems with the industry, and conclude that government has abdicated its steering role in health care and has allowed the private sector to dictate policy. The government has reduced itself to a reactionary role in the health care sector. In adopting a more market-oriented strategy, government should set the rules and limits, but leave practicing to the private sector. Government should ensure that all citizens have health insurance, and help provide healthcare to the poor and elderly. It should work to encourage competition, and at the same time make sure citizens have sufficient information about providers in order to make well-informed choices. Government to provide incentives in order to make healthcare preventive instead of reactive. And finally, the government should push for less hierarchy, advocating for a shift of duties that are inefficiently reserved for highly trained doctors to nurses and physicians assistants.

Education is the second challenging public issue to which the authors apply their principles of entrepreneurial government. They see the educational system as a perfect example of a monopoly and believe much can be done to improve it. Schools have failed to implement progressive change in their methods, and as a result, the system has been on the road to failure over the years and is largely out of synch with the changing family structure.