Agency, Contract, and Governance: Shifting Shapes of Accountability in the Health Care Arena
Why this work is in the frame
A frame that forgets how it found something cannot be audited. These are the routes that admitted this work.
Bibliographic record
Abstract
Current ideas about the role of the state include an enthusiasm for mechanisms of "indirect" or "third-party" governance. The health care arena, in which models of indirect governance have a long history, is an important test bed for these ideas. Classically, the arena was marked by trust-based, principal-agent relationships established to overcome information gaps. Over time (and to different degrees across nations), emphasis shifted to contractual relationships assuming relatively well-informed actors and then to performance monitoring and information sharing within complex and loosely coupled networks. In this latest stage, there is a risk that some important features of democratic leadership, and of decision making in the health care arena, will be eclipsed. Accountability mechanisms must clearly locate responsibility for actions and must allow for the exercise of professional judgment.
Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.004 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from it