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Full Description
One of the most persistent puzzles in comparative public policy concerns the conditions under which discontinuous policy change occurs. In Remaking Policy, Carolyn Hughes Tuohy advances an ambitious new approach to understanding the relationship between political context and policy change.
Focusing on health care policy, Tuohy argues for a more nuanced conception of the dynamics of policy change, one that makes two key distinctions regarding the opportunities for change and the magnitude of such changes. Four possible strategies emerge: large-scale and fast-paced ("big bang"), large-scale and slow-paced ("blueprint"), small-scale and rapid ("mosaic"), and small-scale and gradual ("incremental"). As Tuohy demonstrates, these strategies are determined not by political and institutional conditions themselves, but by the ways in which political actors, individually and collectively, read those conditions to assess their prospects for success in the present and over time.
Drawing on interviews as well as primary and secondary accounts of ten health policy cases over seven decades (1945—2015) in the US, UK, the Netherlands, and Canada, Remaking Policy represents a major advance in understanding the scale and pace of change in health policy and beyond.
Contents
Part I: Overview and theory
Chapter One: Overview
Chapter Two: Defining the Scale and Pace of Policy Change
Part II: The Founding and Evolution of the Health care State to the 1980s
Chapter 3: The Establishment and Evolution of the British and American Health Care States to the 1980s
Chapter Four: The Establishment and Evolution of the Dutch and Canadian Health Care States to the 1980s
Part III: remaking the Health Care State at the Millennium, 1987-2015
Chapter Five: British and American Health Care Reform Strategies, Late 1980s to Late 2000s
Chapter Six: The American Mosaic 2009-2014 - Return to Unfinished Business
Chapter Seven: The English Mosaic 2010-2014 - Evolution in Revolutionary Clothing
Chapter Eight: The Dutch Blueprint 1987-2006
Chapter Nine: Canadian Incrementalism Reinforced, 1995-2004
Part IV: institutional entrepreneurs and the course of Market-oriented reform
Chapter Ten: Institutional Entrepreneurs and Market-Based Reform: Theory and Experience in Britain, the Netherlands and the US
Part v: Conclusion
Chapter Eleven: Understanding Policy Change
