Understanding the Welfare State: The Case of Health Care

Moran, Michael

doi:10.1111/1467-856x.00031

Cited by 157 publications

(142 citation statements)

References 25 publications

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“…Health care, although it has been subject to separate comparative analysis, has been a significant and notable omission from the broader welfare state literature and particularly the regimes debate (Ham, 1997;Moran, 1999Moran, , 2000Freeman and Moran, 2000;Freeman, 2000). Some commentators have drawn passing attention to it as a strong example of internal policy inconsistency.…”

mentioning

confidence: 99%

Worlds of Welfare and the Health Care Discrepancy

Bambra

2005

Social Policy & Society

121

131

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. (2005) 'Worlds of welfare and the health care discrepancy.', Social policy and society., 4 (1). pp. 31-41.Further information on publisher's website: Use policyThe full-text may be used and/or reproduced, and given to third parties in any format or medium, without prior permission or charge, for personal research or study, educational, or not-for-prot purposes provided that:• a full bibliographic reference is made to the original source • a link is made to the metadata record in DRO • the full-text is not changed in any way The full-text must not be sold in any format or medium without the formal permission of the copyright holders.Please consult the full DRO policy for further details.

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mentioning

confidence: 99%

Worlds of Welfare and the Health Care Discrepancy

Bambra

2005

Social Policy & Society

121

131

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“…Indeed, the exciting research agenda spawned by Esping-Andersen's influential research constitutes the basis on which a major strand of comparative health care literature built up hypotheses ). Most studies emulating this framework have been oriented towards the state as the main driver of health care reforms (Bambra 2005;Moran 2002;Wendt 2009;Wendt et al 2009); indeed, these approaches denote the importance of state intervention relative to other actors on one or several dimensions of health care systems. If this highlights the evolving roles of actors, it does not provide sufficient clues as to how generalized policy changes and management practices affect the structure of these systems over time.…”

Section: Typologiesmentioning

confidence: 99%

Roemer 20 Years Later: When a Classical Health-System Typology Meets Market-Oriented Reforms

Bourque¹,

Farrah²

2017

gouvernance

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In 1990, Roemer came up with a very influential health system typology. From his vast study, emerged three types of health care systems: nationalized, mandated and entrepreneurial. Health care systems are not static; slow changes and reforms somewhat alter values and goals on which those systems were initially established. It is fair to say, then, that over the last two decades, health care reformers have adopted a market-oriented governance model that blends new public management (NPM) and managed competition reforms in the provision of health care services to transform supply- and demand-side actors into “responsibilized” customers, payers or providers. These transformations beg the question as to whether we are witnessing a radical redefinition of health care systems through the implementation of market-oriented governance. We propose to add the evolution of market-oriented health reforms in five case studies to Milton Roemer’s typology of health systems. In light of our findings, we will wrap up the analysis with an assessment of the usefulness of Roemer’s classification for social scientists to grasp the evolution of health systems over the past 20 years, and more importantly, to analyze the current state of these health care systems after years of market-oriented reforms.En 1990 Milton J. Roemer a proposé une typologie des systèmes de santé qui eut une influence importante. Cette grille d’analyse propose d’étudier les systèmes de santé à partir de trois grands modèles : les systèmes nationalisés, mandatés et entrepreneuriaux. Ceux-ci sont toutefois en constante évolution. Des changements incrémentaux ainsi que des réformes plus importantes influencent les valeurs et les objectifs qui les avaient inspirés lors de leur mise en oeuvre. Ainsi, depuis deux décennies on peut affirmer que les systèmes de santé ont emprunté les valeurs associées à la nouvelle gestion publique ainsi qu’à la gouvernance de marché dans le but de responsabiliser les consommateurs et les producteurs de soins. Ces transformations importantes posent la question de la redéfinition des systèmes de santé. Autrement-dit, sommes-nous témoins de changements radicaux des soins de santé nationaux qui nécessitent une nouvelle grille d’analyse ? Cet article propose une analyse des dernières réformes des systèmes de santé de cinq pays à la lumière de la typologie de Roemer tout en prenant en compte les éléments liés à l’implantation de la nouvelle gestion publique et de la gouvernance de marché qui ont influencé leur évolution. Dans le cadre de cette analyse nous tenterons d’évaluer la pertinence de la typologie de Roemer pour analyser les systèmes de santé actuels et, de façon plus importante, nous analyserons les systèmes après plusieurs années d’imposition de réformes orientées vers le marché

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“…However, there has been a relative shortage of cross-national analyses of the public share (Bambra, Fox, and Scott-Samuel 2005;Moran 2000;Olafsdottir and Beckfield 2011). Describing the health policy literature, in the Journal of Health Politics, Policy and Law, Blake and Adolino (2001: 679-80) write:…”

Section: Past Researchmentioning

confidence: 99%

Path Dependency and the Politics of Socialized Health Care

Brady¹,

Marquardt²,

Gauchat³

et al. 2016

Journal of Health Politics, Policy and Law

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Rich democracies exhibit vast cross-national and historical variation in the socialization of health care. Yet, cross-national analyses remain relatively rare in the health policy literature and health care remains relatively neglected in the welfare state literature. We analyze pooled time series models of the public share of total health spending for eighteen rich democracies from 1960 to 2010. Building on path dependency theory, we present a strategy for modeling the relationship between the initial 1960 public share and the current public share. We also examine two contrasting accounts for how the 1960 public share interacts with conventional welfare state predictors: the self-reinforcing hypothesis expecting positive feedbacks and the counteracting hypothesis expecting negative feedbacks. We demonstrate that most of the variation from 1960 to 2010 in the public share can be explained by a country's initial value in 1960. This 1960 value has a large significant effect in models of 1961-2010, and including the 1960 value alters the coefficients of conventional welfare state predictors. To investigate the mechanism whereby prior social policy influences public opinion about current social policy, we use the 2006 International Social Survey Programme (ISSP). This analysis confirms that the 1960 values predict individual preferences for government spending on health. Returning to the pooled time series, we demonstrate that the 1960 values interact significantly with several conventional welfare state predictors. Some interactions support the self-reinforcing hypothesis, while others support the counteracting hypothesis. Ultimately, this study illustrates how historical legacies of social policy exert substantial influence on the subsequent politics of social policy.

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Understanding the Welfare State: The Case of Health Care

Cited by 157 publications

References 25 publications

Worlds of Welfare and the Health Care Discrepancy

Worlds of Welfare and the Health Care Discrepancy

Roemer 20 Years Later: When a Classical Health-System Typology Meets Market-Oriented Reforms

Path Dependency and the Politics of Socialized Health Care

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