Hostname: page-component-8448b6f56d-xtgtn Total loading time: 0 Render date: 2024-04-16T21:14:35.946Z Has data issue: false hasContentIssue false
  • English
  • Français

Path Dependency, or Why History Makes It Difficult but Not Impossible to Reform Health Care Systems in a Big Way

Published online by Cambridge University Press:  28 November 2008

David Wilsford
David Wilsford
Affiliation:
Political Scientist, Georgia Institute of Technology
Get access Rights & Permissions [Opens in a new window]

Abstract

The idea of path-dependency is applied to an examination of health policy reform in Germany, France, Great Britain and the United States. In the path-dependent model, actors are hemmed in by existing institutions and structures that channel them along established policy paths. Therefore, in any system, big (non-incremental) change is unlikely. However, sometimes we do observe big change. Why? By developing the interplay of structure with conjuncture, the occasional accomplishment of big change - in spite of path dependency - can be systematically understood.

Type
Articles
Information
Journal of Public Policy , Volume 14 , Issue 3 , July 1994 , pp. 251 - 283
Copyright
Copyright © Cambridge University Press 1994

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

REFERENCES

Baumgartner, F., and Jones, B. D. (1993) Agendas and Instability in American Politics, Chicago: University of Chicago Press.Google Scholar
Credes, (1993) Eco-Santé, Paris: Centre de Recherches et de la Documentation en Economic de la Santé.Google Scholar
David, P. A. (1985) “Clio and the Economics of QWERTY”, American Economic Review 75, 332–337.Google Scholar
David, P. A. (1989) “A Paradigm for Historican Economics: Path Dependence and Predictability in Dynamic Systems with Local Network Externalities”, Stanford CA: Center for Economic Policy Research, Stanford University.Google Scholar
Evans, P. B., Rueschemeyer, D., Skocpol, T., eds. (1985) Bringing the State Back In, New York: Cambridge University Press.CrossRefGoogle Scholar
Giaimo, S. (1993) “Health Care Reform in Britain and Germany: Recasting the Political Bargain with the Medical Procession”, Washington DC: Annual Meeting of the American Political Science Association.Google Scholar
Gleick, J. (1987) Chaos: Making a New Science, New York: Penguin.Google Scholar
Ham, C. (1992) Health Policy in Britain: The Politics and Organisation of the National Health Service, London: Macmillan.Google Scholar
Harrison, S., and Pollitt, C. (1994) Controlling Health Professionals: The Future of Work and Organization in the NHS, Buckingham: Open University Press.Google Scholar
Hassenteufel, P. (1994a) La profession médicale face a l'Etat: Une comparaison Francel Allemagne, Paris: Doctoral thesis, Unversité Paris I.Google Scholar
Hassenteufel, P. (1994b) “Allemagne: Les effets de la reforme structurelle de l'assurance-maladie”, Chronique Internationale 27, mars: 28–33.Google Scholar
Immergut, E. (1992) Health Politics: Interests and Institutions in Western Europe, New York: Cambridge University Press.Google Scholar
Kingdon, J. (1984) Agendas, Alternatives, and Public Policies, Boston: Little Brown.Google Scholar
Kriegel, R. (1992) L'Assurance maladie et sa réforme en République Fédérate Allemande, Strasbourg: Caisse Régionale d'Assurance-Maladie Alsace-Moselle.Google Scholar
Kriegel, R. (1993) Allemagne: Loi pour une réforme de structure en matiére de santé du 21.12.1992, Strasbourg: Caisse Régionale d'Assurance-Maladie Alsace-Moselle.Google Scholar
Leman, C. (1980) The Collapse of Welfare Reform: Political Institutions, Policy and the Poor in Canada and the United States, Cambridge MA: MIT Press.Google Scholar
March, J. G., and Olsen, J. P. (1989) Rediscovering Institutions: The Organizational Basis of Politics, New York: Free Press.Google Scholar
Manner, T. (1970) The Politics of Medicare, London: Routledge and Kegan Paul.Google Scholar
Oecd, (1993) Health Data, Paris: Organization for Economic Cooperation and Development.Google Scholar
Pressman, J., and Wildavsky, A. (1984) Implementation, Berkeley: University of California Press.Google Scholar
Robinson, R., and Legrand, J. (1994) Evaluating the NHS Reforms, London: King's Fund Institute.Google Scholar
Rodwin, V. (1982) “Management without Objectives: The French Health Policy Gamble”, in McLachlan, G. and Maynard, A., eds., The Public/Private Mix for Health, London: Nuffield Hospitals Trust.Google Scholar
Rose, R. (1990) “Inheritance before Choice in Public Policy”, Journal of Theoretical Politics 2, 3:263–290.CrossRefGoogle Scholar
Steinmo, S., Thelen, K., and Longstreth, F., eds (1992) Structuring Politics: Historical Institutionalism in Comparative Analysis, New York: Cambridge University Press.CrossRefGoogle Scholar
Wilsford, D. (1985) “The Conjoncture of Ideas and Interests”, Comparative Political Studies 18, 3:357–372.CrossRefGoogle Scholar
Wilsford, D. (1991) Doctors and the State: The Politics of Health Care in France and the United States, Durham NC: Duke University Press.Google Scholar
Wilsford, D. (1993) “The Medical Profession in France”, in Hafferty, F. W. and McKinlay, J. B., eds., The Changing Medical Profession: An International Perspective, New York: Oxford University Press.Google Scholar