Distributed Democracy: Health Care Governance in Ontario

"In Distributed Democracy, Carey Doberstein analyses the relationship between democracy and accountability by taking a holistic view of a complex ‘deliberative ecosystem’: health governance in Ontario. The book’s compelling analytical framework and extensive empirical research make it valuable to scholars of health policy, public policy and governance, and democratic theory, as well as to policymakers and reformers in a range of complex governance arenas. Doberstein argues that the appropriate response to a sometimes ‘messy or fuzzy’ process of policymaking is not to abandon attempts at deliberative governance but rather to carefully assign criticism and reform efforts where they are most needed. This book provides an invaluable basis for doing so."

Katherine Boothe, Department of Political Science, McMaster University

"Carey Doberstein’s book will stand as the reigning analysis and critique of Ontario’s fifteen-year experiment with Local Health Integration Networks as mechanisms of health care governance, offering penetrating insights into the strengths and weaknesses of what he terms this ‘deeply controversial and often misunderstood model.’ Beyond that significant contribution, however, Doberstein’s treatment of the LHINs within an original ‘democratic arenas framework’ provides an illuminating approach to the study of experimentalist governance well beyond the case of the LHINs and indeed beyond the health care arena itself."

Carolyn Tuohy, Munk School of Global Affairs and Public Policy, University of Toronto