Accidental Logics: The Dynamics of Change in the Health Care Arena in the United States, Britain, and Canada (Hardcover)

by Carolyn Hughes Tuohy (Author) "In the last two decades of the twentieth century, health care was not far from the top of the policy agenda in any advanced industrial..." (more)
Key Phrases: individual billing thresholds, physician services budget, hierarchical corporatism, United States, British Columbia, Canada Health Act (more...)

Editorial Reviews

Review

"Combining a mastery of empirical data and of theory, Professor Tuohy has produced the most sophisticated and illuminating account yet of how and why nations differ in their health policies. An indispensable read for health policy specialists, it is also an invaluable addition to the comparativist literature."--Rudolf Klein, Senior Associate, King's Fund, London
"Carolyn Tuohy's new book is splendid, the most significant scholarly work in comparative health politics and policy in the last two decades. Aiming to understand both change and continuity in American, Canadian, and British medical policy in the half-century after W.W.II, Tuohy manages both to do that and to make a theoretical contribution to the political analysis of public policy. No other recent work is of comparable scope and skill--a book, in short, worth reading by anyone seriously interested in politics, economics, and sociology of modern medical care."--Theodore R. Marmor, Professor of Public Policy & Management, Yale University
"Accidental Logics is a terrific book. Carolyn Tuohy makes the extraordinarily complex world of health care reform understandable even to non-experts, showing how past policy choices have caused three countries to address health care cost pressures in strikingly different ways. It is must reading for serious students of the welfare state."--Kent Weaver, Senior Fellow in Governmental Studies, The Brookings Institution
"An intellectually exciting book. An important theoretical contribution on path dependency in public policy, and a compelling reminder that different countries can and do chart distinctive approaches to heath care even in a global era."--Keith Banting, School of Policy Studies, Queen's University, Ontario
"The impressive book gives a detailed account of how different countries have responded to new but similar problems in the area of health care. It emphasizes the persistence of national traditions and the impact of decisions taken decades ago on current change, thus providing a clear and convincing application of the path dependency thesis. But it goes further than this by specifying the conditions that permit structural change in health care policy. In this respect, it marks a major step forward in our understanding of how health policy, and public policies in general, are made."--Ian Gough, Department of Social and Policy Sciences, University of Bath


Product Description
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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Product Details

• Hardcover: 328 pages
• Publisher: Oxford University Press, USA; 1 edition (May 20, 1999)
• Language: English
• ISBN-10: 0195128214
• ISBN-13: 978-0195128215
• Product Dimensions: 9.4 x 6.4 x 1.1 inches
• Shipping Weight: 1.6 pounds (View shipping rates and policies)
• Average Customer Review: 4.0 out of 5 stars See all reviews (1 customer review)
• Amazon.com Sales Rank: #743,069 in Books (See Bestsellers in Books)

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0 of 1 people found the following review helpful:

4.0 out of 5 stars germane to the US 2008 federal election, October 22, 2008

By	W Boudville (Terra, Sol 3) - See all my reviews (TOP 50 REVIEWER)    (REAL NAME)

A major bone of contention between Barack Obama and John McCain has been over health care for Americans. In the 2008 presidential debates and on the campaign trail, big differences have merged over their plans.

If you are seriously interested in the topic, you might want to step back and peruse this book. Written in 1999, it takes a dispassionate look at health care plans in the US, Britain and Canada during the 80s and 90s. The comparative analysis lends some perspective about the merits of different plans and about universal health care versus some type of privatised scheme.

Problems with how universal health care was implemented in Britain and Canada are aired. These suggest that this approach is no panacea. But the book also delves in the flaws with the American system, especially the vast numbers with little or no health care.