Intro -- Contents -- 1. Understanding the Dynamics of Change in the Health Care Arena -- The Conceptual Framework: The Accidental Logics of Change in Policy Arenas -- Dimensions of Decision-Making Systems: Institutional Mix and Structural Balance -- Policy Episodes and System Logics -- The Economics of Health Care Delivery: Agency, Risk, and Localism -- The Health Policy Agenda of the 1990s -- Britain, the United States, and Canada -- PART I. EPISODES OF POLICY CHANGE -- 2. The Establishment of the Welfare State in the Health Care Arena -- The Immediate Postwar Period: Britain versus Canada and the United States -- The 1950s and 1960s: The Establishment of Governmental Health Insurance in Canada and the United States -- 3. The Reforms of the 1990s -- Britain -- The United States -- Canada -- 4. Institutions, Ideas, Interests, Actors, and the Accidents of Policy Episodes -- Political Institutions -- Policy Legacies and Path Dependency -- Public Opinion and Cultural Understandings -- Political Culture and Parties -- Interests -- Strategic Judgment -- Understanding Policy Episodes -- PART II. THE DISTINCTIVE LOGICS OF NATIONAL SYSTEMS -- 5. The United States: The Logic of the Mixed Market -- Regulation in the 1970s -- Prospective Payment in the 1980s -- The Rise of "Managed Care -- Regional versus National Markets -- The Growing Role of For-Profits -- Performance Monitoring and the Role of Clinical Judgment -- Information and Information Technology -- The Changing Political Terrain -- Institutional and Structural Change in the Mixed Market -- The Logic of Entrepreneurialism -- 6. Britain: The Logic of Corporatism Meets the Internal Market -- Corporatism in the NHS -- Managerialism and the Griffiths Reforms -- The Purchaser-Provider Split: Bargaining in the Internal Market -- Bargaining Roles: The Provider Side -- Bargaining Roles: The Purchaser Side.

Clinical Audit and the Role of Clinical Judgment -- Information and Information Technology -- The Role of the Private Sector -- The Role of Partisan and Electoral Politics -- Institutional and Structural Change in the Internal Market -- The Logic of the Internal Market -- 7. Canada: The Logic of the Single-Payer System -- The Founding Bargain: Fee-for-Service and the Negotiation of Price -- Provincial-Level Accommodations in the 1970s and 1980s -- Expenditure Caps in the 1990s -- The Expanding Agenda -- Information and Information Technology -- Changing Profession-Government Relations and the Impact on Organized Medicine -- The Logic of the Profession-State Accommodation -- Institutional and Structural Change in a Single-Payer System -- 8. Conclusion -- The Health Policy Arena in Britain, the United States, and Canada -- Concluding Observations -- Notes -- References -- Index -- A -- B -- C -- D -- E -- F -- G -- H -- I -- J -- K -- L -- M -- N -- O -- P -- Q -- R -- S -- T -- U -- V -- W.

What drives change in health care systems? Why do certain changes occur in some nations and not in others? Author Carolyn Hughes 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. Tuohy looks at the experiences of Britain, Canada, and the US, offering an international comparative study of public policy systems, as well as a recent history of the circumstances in each country that have impacted on the structures of each's national health care system. The guiding focus of the book is Tuohy's study of decision making systems in each country, looking at the decisions made by those who provide, finance, and use health care services. Finally, Tuohy reviews current issues in the health care arenas of these three nations and provides suggestions to guide the strategic judgments that decision-makers must make.

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Electronic reproduction. Ann Arbor, Michigan : ProQuest Ebook Central, 2018. Available via World Wide Web. Access may be limited to ProQuest Ebook Central affiliated libraries.