Why do public policies fail so often? Exploring health policy-making as an imaginary and symbolic construction
运用拉康精神分析理论中的欲望主体和社会象征秩序概念，提出公共政策也是社会幻想的产物，并借助克莱因客体关系理论解释政策转化为组织实践的困难，以英国NHS患者选择为例说明如何将幻想与现实结合来理解政策制定。
Although it is widely accepted that public policies are difficult to implement, most analyses of policy failures are conceived of as predominantly rational processes. This article questions that assumption by introducing ideas of a desiring subject and socio-symbolic order drawn from Lacanian psychoanalytic theory to suggest that public policies are also a product of social fantasy, and to draw attention to the implications of this unrecognized function of policy-making. It also employs the idea of defensive splitting borrowed from Kleinian object relations theory to explain the difficulty of translating policy into public organizations, which have to perform often conflicting societal tasks. The example of patient choice in the UK National Health Service (the NHS) is used to illustrate theoretical arguments and to propose an alternative understanding of public policy-making by way of bridging fantasy with reality.