However one interprets the results of the Health and Human Services reorganization, the process of consolidation and privatization of public health and human services agencies in Texas provides a window into the following observations about the state bureaucracy:
The bureaucracy tends to be weak and fragmented in Texas, even those departments and agencies that manage considerable sums of money and thousands of employees. The health bureaucracy in Texas was a sprawling, complex apparatus prior to the reorganization (and it may continue this way even after the HHS reorganization).
In recent years there has been a moderate short-term trend toward centralization of executive branch authority under the governor in Texas. The argument that some degree of centralization would increase effectiveness was offered as one justification for the HHS reorganization. But centralization is often a political end in itself. Indeed, the greater potential for abuse of authority in a more centralized bureaucracy is a central concern.
The bureaucracy receives large amounts of federal money for administration, equipment and programs, and as such is subject to considerable federal oversight. All efforts to reorganize the health bureaucracy in Texas, including the 2003 effort, required taking into account federal guidelines and funding formulas.
While the bureaucracy is often derided for being wasteful, inefficient, unresponsive, and meddling, many powerful groups seek to control its resources. This is a critical point, elaborated in both this chapter and the political economy chapter.
In the current era of fiscal crisis in state government across the country, new, often radical experiments are being implemented to streamline bureaucratic operations. But such innovations are always filtered and refracted through the prism of existing political forces and institutions on the local, state and federal levels.
