Accidental Logics
The Dynamics of Change in the Health Care Arena in the United States, Britain, and Canada
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Product details:
- Publisher OUP USA
- Date of Publication 11 November 1999
- ISBN 9780195128215
- Binding Hardback
- No. of pages328 pages
- Size 240x162x28 mm
- Weight 653 g
- Language English 0
Categories
Short description:
Accidental Logics provides answers to what drives change in health care systems and why certain types of changes occur in some countries, by focusing on the experiences of the United States, Britain, and Canada. Tuohy examines the "accidents" of history that have shaped national systems at critical moments in time and the distinctive "logics" of the systems thus created. This book should be read by political scientists, public policy makers, and those involved in health care, including administrators and practitioners.
MoreLong description:
Health care reform has become one of the most prevalent topics in recent policy discourse within and across nations. In the 1990s, common features of the health care arena elevated the importance of bargaining relationships among large, sophisticated entities as the dominant mode of decision-making, fundamentally challenging the traditional dominance of the medical profession, which had been grounded in individualized "agency" relationships between providers and patients. These developments have played out in varying ways around the globe. Carolyn Hughes Tuohy looks at the experiences of the United States, Britain, and Canada, offering an international comparative study of public policy systems, as well as a recent history of the evolution of each national health care system.
What drives change in health care systems? Why do certain changes occur in some nations and not in others? Tuohy argues that the answer lies in understanding the "accidents" of history that have shaped national systems at critical moments and in the distinctive "logics" of these systems. Her study carefully delineates both the common logic of the health care arena, deriving from micro-economic characteristics and technological change, and the particular logics of national systems, put in place by specific episodes of policy change. She goes on to explore how in the wake of these episodes, the mixed market in the United States, hierarchical corporatism in Britain, and the single-payer system in Canada determined the subsequent direction and pace of change in all three countries. Finally, Tuohy provides suggestions to guide the strategic judgments that decision-makers must make within the health care system of each country. Accidental Logics uniquely departs from the descriptive literature currently available by presenting an extensive review of the evidence regarding the evolution of the health care arenas in the United States, Britain, and Canada, integrated within an explanatory framework. It is essential up-to-date reading for political scientists working in comparative politics and public policy, health policy analysts, government agency officials, and students in political science, health policy, and administration programs.
Combining a mastery of empirical data and of theory, Professor Tuohy has produced the most sophisticated and illuminating account yet of how and why nations differ in their health policies. An indispensable read for health policy specialists, it is also an invaluable addition to the comparativist literature.
Table of Contents:
Introduction
Understanding the Dynamics of Change in the Health Care Arena
Part I: Episodes of Policy Change
The Establishment of the Welfare State in the Health Care Arena
The Reforms of the 1990s
Ideas, Institutions, Interests, and Actors and the Accidents of Policy Episodes
Part II: The Distinctive Logics of National Systems
The US: The Logic of the Mixed Market
Britain: The Logic of Corporatism Meets the Internal Market
Canada: The Logic of the Single-Payer System
Conclusion
References
Index
