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

By Carolyn Hughes Tuohy

What drives swap in well-being 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 figuring out the "accidents" of historical past that experience formed nationwide platforms at serious moments, and within the certain "logics" of those platforms. Tuohy appears on the reports of england, Canada, and the USA, delivering a world comparative learn of public coverage platforms, in addition to a up to date background of the conditions in every one state that experience impacted at the buildings of each's nationwide wellbeing and fitness care procedure. The guiding concentration of the publication is Tuohy's research of determination making platforms in every one state, taking a look at the selections made through those that offer, finance, and use future health care companies. ultimately, Tuohy studies present matters within the future health care arenas of those 3 international locations and offers feedback to steer 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

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One, underlying the federal Medicare program for the elderly and disabled and the federal-state Medicaid program for the indigent, covering less than one-quarter of the population, was based on direct government subsidization of health care costs. The organization of health care delivery, moreover, was decentralized among myriad privately constituted and autonomous entities. S. system, the state clearly played an important though different role, both fiscal and regulatory. Furthermore, the prevailing market model in theory (and for most of its history in practice) allowed physicians both entrepreneurial discretion and clinical autonomy.

1996: 109—19). Services "delisted" (that is, removed from the list of publicly insured services) in a number of Canadian provinces related primarily to cosmetic procedures and some services related to reproduction, such as reversal of vasectomies and in-vitro fertilization. : 118). In Sweden, the Netherlands, and New Zealand, government commissions appointed to consider the appropriate scope of a basic package of publicly insured services produced sets of criteria, without defining the actual services to be included or excluded.

S. system that made for this degree of change without major change in public policy? 34 Understanding the Dynamics of Change in the Health Care Arena Finally, there is a Canadian puzzle. Yet it experienced one of the lowest levels of institutional and structural change in the 1980s and 1990s.

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