Health care reform has become one of the most prevalent topics in recent policy discourse within and across nations. In the 1990s, common features of the health care arena elevated the importance of bargaining relationships among large, sophisticated entities as the dominant mode of decision-making, fundamentally challenging the traditional dominance of the medical profession, which had been grounded in individualized "agency" relationships between providers and patients. These developments have played out in varying ways around the globe. Carolyn Hughes Tuohy looks at the experiences of the United States, Britain, and Canada, offering an international comparative study of public policy systems, as well as a recent history of the evolution of each national health care system. L What drives change in health care systems? Why do certain changes occur in some nations and not in others? 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. Her study carefully delineates both the common logic of the health care arena, deriving from micro-economic characteristics and technological change, and the particular logics of national systems, put in place by specific episodes of policy change. She goes on to explore how in the wake of these episodes, the mixed market in the United States, hierarchical corporatism in Britain, and the single-payer system in Canada determined the subsequent direction and pace of change in all three countries. Finally, Tuohy provides suggestions to guide the strategic judgments that decision-makers must make within the health care system of each country. Accidental Logics uniquely departs from the descriptive literature currently available by presenting an extensive review of the evidence regarding the evolution of the health care arenas in the United States, Britain, and Canada, integrated within an explanatory framework. It is essential up-to-date reading for political scientists working in comparative politics and public policy, health policy analysts, government agency officials, and students in political science, health policy, and administration programs.
"This collection of essays provides an analysis of Canadian/U.S. social policy toward aging. The first chapter presents a continental view of demography. Subsequent chapters examine the Canadian and U.S. perspectives on social policy, long-term care, the chronic mentally ill, rural aging, aging veterans, native elders, and cross-national intergenerational families." Current Literature on Aging
Governments everywhere have a newfound interest in privatizing healthcare services. This collection explores the deep-rooted tensions between publicly-funded health care systems and the dynamics of public markets to deliver privately-financed health care. It explains the attraction and limitations of market-led health reform and the indispensable role of a vibrant public authority in the renewal of modern health care systems. International authorities in the field examine public-private conflicts in health policy including cost-containment and privatization strategies in an international perspective, and the role of business and the private sector in setting the agenda for health care reform. The contributors focus on the restructuring of Anglo-Saxon health systems and the shift in state-market boundaries in Canada, the US, Britain and Australia.