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

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

byCarolyn Hughes Tuohy

Hardcover | April 1, 1999

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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 ofdecision-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 theexperiences 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 studycarefully 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, themixed 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 thehealth 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 explanatoryframework. 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.

About The Author

Carolyn Hughes Tuohy is at University of Toronto.

Details & Specs

Title:Accidental Logics: The Dynamics of Change in the Health Care Arena in the United States, Britain…Format:HardcoverPublished:April 1, 1999Publisher:Oxford University PressLanguage:English

The following ISBNs are associated with this title:

ISBN - 10:0195128214

ISBN - 13:9780195128215

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Extra Content

Table of Contents

IntroductionCh. 1. Understanding the Dynamics of Change in the Health Care ArenaPart I: Episodes of Policy ChangeCh. 2. The Establishment of the Welfare State in the Health Care ArenaCh. 3. The Reforms of the 1990sCh. 4. Ideas, Institutions, Interests, and Actors and the Accidents of Policy EpisodesPart II: The Distinctive Logics of National SystemsCh. 5. The US: The Logic of the Mixed MarketCh. 6. Britain: The Logic of Corporatism Meets the Internal MarketCh. 7. Canada: The Logic of the Single-Payer SystemCh. 8. ConclusionReferencesIndex

Editorial Reviews

"A useful and insightful explanation of changes in these three countries' health care systems over the past several decades."--Choice