Download Accidental Logics: The Dynamics of Change in the Health Care by Carolyn Hughes Tuohy PDF

By Carolyn Hughes Tuohy

ISBN-10: 0195128214

ISBN-13: 9780195128215

What drives swap in overall healthiness care structures? Why do definite alterations happen in a few countries and never in others? writer Carolyn Hughes Tuohy argues that the reply lies in figuring out the "accidents" of heritage that experience formed nationwide structures at serious moments, and within the distinct "logics" of those platforms. Tuohy seems on the reviews of england, Canada, and the united states, supplying a world comparative examine of public coverage platforms, in addition to a contemporary background of the conditions in each one state that experience impacted at the buildings of each's nationwide well-being care approach. The guiding concentration of the ebook is Tuohy's examine of choice making structures in each one state, the choices made via those that offer, finance, and use future health care companies. ultimately, Tuohy studies present concerns within the well-being care arenas of those 3 international locations and gives feedback to steer the strategic judgments that decision-makers needs to make.

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Accidental Logics: The Dynamics of Change in the Health Care Arena in the United States, Britain, and Canada

What drives swap in overall healthiness care platforms? Why do yes adjustments ensue in a few countries and never in others? writer Carolyn Hughes Tuohy argues that the reply lies in figuring out the "accidents" of historical past that experience formed nationwide platforms at serious moments, and within the unique "logics" of those platforms.

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Extra resources for Accidental Logics: The Dynamics of Change in the Health Care Arena in the United States, Britain, and Canada

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But they also share important characteristics that can frame a comparative analysis. In the first place, they share a broadly similar tradition of state—society relations which, among other things, implies an autonomous base for professions vis-a-vis the state, in contrast to the more "statist" or "state-corporatist" model of continental Europe (Rueschemeyer 1986; Stone 1977: 38-39). They also share a roughly similar structure for the organization of capital, with a distinction between "real" and "financial" capital and a heavy reliance on equity markets, again in contrast to a more integrated continental European model (Zysman 1983; Hall 1986: 229—83).

The model of an integrated geographically based hierarchy for health care financing and delivery also developed in different variants in Ireland, the Scandinavian countries, and New Zealand, and through the transformation of the corporatist social insurance systems of Italy, Portugal, and Spain in the 1970s and 1980s (Elola 1996; Flood 1996; Ferrara 1995; Rodriguez 1995). Each of these national systems also accorded varying degrees of weight to other sets of actors and instruments as well: all, for example, continued to allow for various admixtures of public and private finance through copayments or parallel private sectors.

In the 1990s, however, the incremental assertion of state power vis-a-vis the profession in state-sponsored systems was increasingly noted (Moran 1994; Wilsford 1995; Johnson 1995). Commenting on these observations, Donald Light has made the important point that these trends need to be understood in the context of the "historical dynamics" between the medical profession and other 30 Understanding the Dynamics of Change in the Health Care Arena actors within the health care arena. He proposes that these relationships be conceptualized as occurring within a field of forces that is in a state of ongoing change.

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