Institutions, institutionalized networks and policy choices: Health policy in the US and Canada

• 成果类型: Review
• 署名作者: Boase, JP
• 刊物名称: GOVERNANCE-AN INTERNATIONAL JOURNAL OF POLICY ADMINISTRATION AND INSTITUTIONS
• ISSN/ISSBN: 0952-1895
• DOI: 10.1111/j.1468-0491.1996.tb00244.x
• 发表日期: 1996
• 关键词: UNITED-STATES; insurance; REFORM; 1990s

摘要

This article uses the case of health insurance policy in the United States and Canada, to try to explain how particular state-societal patterns of intermediation unfold, become institutionalized and effect quite different policy strategies. It begins by outlining the importance of formal political and administrative institutional structure in the exercise of autonomous state action. It then examines the concepts of policy community and policy network as state-specific vehicles of interest intermediation and finally, it grounds the theoretical discussion in a comparative description of the evolution of health policy in the United Stares and Canada. It concludes that to a great extent, we are the prisoners of our institutions-both political and societal-and without fundamental change, necessitating major upheaval, the United States is unlikely to embrace a national health insurance program similar to other western nations.