New PDF release: Accidental Logics: The Dynamics of Change in the Health Care

By Carolyn Hughes Tuohy

ISBN-10: 0195128214

ISBN-13: 9780195128215

What drives switch in health and wellbeing care structures? Why do convinced alterations happen in a few countries and never in others? writer Carolyn Hughes Tuohy argues that the reply lies in realizing the "accidents" of background that experience formed nationwide structures at severe moments, and within the precise "logics" of those platforms. Tuohy appears to be like on the reviews of england, Canada, and the USA, providing a global comparative learn of public coverage structures, in addition to a contemporary background of the situations in every one state that experience impacted at the constructions of each's nationwide wellbeing and fitness care procedure. The guiding concentration of the ebook is Tuohy's examine of selection making platforms in every one state, the choices made by means of those that offer, finance, and use health and wellbeing care prone. eventually, Tuohy stories present concerns within the future health care arenas of those 3 international locations and gives feedback to lead the strategic judgments that decision-makers needs to make.

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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

Sample text

But they do establish the conditions in which the policy "problem" and the range of behavioral responses are defined. At the heart of the economics of health care delivery is the "agency" relationship between the health care provider (quintessentially the physician) and the patient. Three characteristics of health care—information asymmetry, the difficulty of evaluating the product, and high costs of error—mean that it is rational for consumers of health care to establish agency relationships with providers, that is, to delegate decision-making authority to providers to choose the care required by the consumer.

In those states where the government has played a central role in nurturing professions within the state structure but has allowed the professions to establish their own institutions and power base, the professions and the state go through phases of harmony and discord in which countervailing actions take place. In states where the medical profession has been largely suppressed, we now see their rapid reconstitution once governmental oppression is lifted. (Light 1995:26-27) Light also highlights the importance of understanding alliances among parties in a field of countervailing powers, noting that these alliances, such as that between the medical profession and private corporations in the United States, are often characterized by "structural ambiguities" and ambivalence, given the conflicting as well as common interests of the parties (Light 1995:27).

The federal legislation establishing the medicare program set very broad parameters, requiring that provincial programs, in order to qualify for federal financial contributions, conform to five principles— universality, comprehensiveness, accessibility, portability, and public administration. The resulting provincial programs centralized the financing of medical and hospital services in the provincial governments (with federal contributions), while leaving the decentralized delivery system in place.

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


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