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Roadblocks to Reform: Beyond the Usual Suspects

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  • Grignon Michel

    ()
    (Department of Economics, Centre for Health Economics and Policy Analysis, McMaster University)

Abstract

Real reforms attempt to change how health care is financed and how it is rationed. Three main explanations have been offered for why such reforms are so difficult: institutional gridlock, path dependency and societal preferences. The latter posits that choices made regarding the health care system in a given country reflect the broader societal set of values in that country and that, as a result, public resistance to real reform may more accurately reflect citizensÕ personal convictions, self-interest or even active social choices. ÒConscientious objectorsÓ may do more to derail reform than previously recognized.

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File URL: http://www.chepa.org/docs/working-papers/12-01.pdf
File Function: First version, 2012
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Paper provided by Centre for Health Economics and Policy Analysis (CHEPA), McMaster University, Hamilton, Canada in its series Centre for Health Economics and Policy Analysis Working Paper Series with number 2012-01.

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Date of creation: 2012
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Handle: RePEc:hpa:wpaper:201201

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  1. Light, Donald W., 2011. "Historical and comparative reflections on the U.S. national health insurance reforms," Social Science & Medicine, Elsevier, vol. 72(2), pages 129-132, January.
  2. Thomasson, Melissa A., 2002. "From Sickness to Health: The Twentieth-Century Development of U.S. Health Insurance," Explorations in Economic History, Elsevier, vol. 39(3), pages 233-253, July.
  3. Miguel Gouveia, 1997. "Majority rule and the public provision of a private good," Public Choice, Springer, vol. 93(3), pages 221-244, December.
  4. Michel Grignon, 2009. "Pourquoi les systèmes de santé sont-ils organisés différemment ?," Revue économique, Presses de Sciences-Po, vol. 60(2), pages 545-558.
  5. Jacob, Johanna & Lundin, Douglas, 2005. "A median voter model of health insurance with ex post moral hazard," Journal of Health Economics, Elsevier, vol. 24(2), pages 407-426, March.
  6. Abelson, Julia & Miller, Fiona A. & Giacomini, Mita, 2009. "What does it mean to trust a health system?: A qualitative study of Canadian health care values," Health Policy, Elsevier, vol. 91(1), pages 63-70, June.
  7. Kenworthy, Lane, 2000. "Quantitative indicators of corporatism: A survey and assessment," MPIfG Discussion Paper 00/4, Max Planck Institute for the Study of Societies.
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