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.

dental care, evaluation, healthcare markets, policy experiments, politics
dx.doi.org/10.1177/1356389017750194, hdl.handle.net/1765/104201
Evaluation: international journal of theory, research and practice
Erasmus School of Health Policy & Management (ESHPM)

Felder, M, van de Bovenkamp, H.M, & de Bont, A.A. (2018). Politics of policy learning: Evaluating an experiment on free pricing arrangements in Dutch dental care. Evaluation: international journal of theory, research and practice, 24(1), 6–25. doi:10.1177/1356389017750194