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

By Carolyn Hughes Tuohy

What drives switch in wellbeing and fitness care platforms? Why do yes adjustments ensue in a few international locations and never in others? writer Carolyn Hughes Tuohy argues that the reply lies in realizing the "accidents" of heritage that experience formed nationwide structures at severe moments, and within the certain "logics" of those platforms. Tuohy seems on the reports of england, Canada, and the united states, delivering a world comparative examine 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 well-being care method. The guiding concentration of the publication is Tuohy's learn of determination making platforms in every one nation, the selections made through those that supply, finance, and use health and wellbeing care companies. ultimately, Tuohy experiences present matters within the healthiness 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 info for Accidental Logics: The Dynamics of Change in the Health Care Arena in the United States, Britain, and Canada

Example text

This paradigm is a response to the mirror weaknesses inherent in the "old" opposing paradigms of state-driven systems on the one hand and market-driven systems on the other. Under a hierarchical state system, quintessentially represented by the British National Health Sevice (NHS) prior to 1990, all three functions were combined, and the incentives to innovation and efficiency associated with the market were allegedly lacking. Under traditional market-driven systems of medical insurance in which third-party payers played a more or less passive financing role, the three functions were completely separated, and those making the actual purchasing decisions were individuals lacking the resources to make sophisticated decisions.

The Economics of Health Care Delivery: Agency, Risk, and Localism Certain fundamental characteristics of the economics of health care delivery are common across nations. These characteristics do not determine the nature 16 Understanding the Dynamics of Change in the Health Care Arena of public policies regarding the organization and financing of health care, nor of the behavior of actors within the parameters established by public policy, as is evidenced by wide cross-national variations in these respects.

Canadian medicare bears the marks of its birth in the 1960s, an era of high public expectations and government expansiveness, in which the indemnity model of private insurance had become established and the public underwriting of the costs of a professionally dominated system appeared feasible. S. Medicare and Medicaid systems were born in the same period, and were fashioned on a similar model. But as we shall see they were introduced in a national context in which the legacy of past policy failures conditioned policy-makers to adopt an incremental approach that ironically sowed the seeds of future policy failures.

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