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The Dynamics of the Dutch Health Care System--A Discourse Analysis


  • Kor Grit
  • Wilfred Dolfsma


In this article, we analyze recent dynamics of the Dutch health care sector, a hybrid system of public, private and professional elements, in terms of clashing discourses. Although these elements are intricately interwoven, this does not mean that the system is stable. Most notably, since the eighties the introduction of more market elements in the health care system has been widely debated. Hospitals introduced different methods commonly used in businesses, for instance. The position of managers in the institutions of health care has become more central. A discourse analysis shows the concomitant patterns of institutional change in the health care sector. We distinguish four different discourses concerning health care: economic, political, medical-professional and caring discourses. These different discourses give rise to, for example, different views of good care, the character and position of the patient, and leadership in health care organizations--views that sometimes clash intensely.

Suggested Citation

  • Kor Grit & Wilfred Dolfsma, 2002. "The Dynamics of the Dutch Health Care System--A Discourse Analysis," Review of Social Economy, Taylor & Francis Journals, vol. 60(3), pages 377-401.
  • Handle: RePEc:taf:rsocec:v:60:y:2002:i:3:p:377-401 DOI: 10.1080/0034676021000013377

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    References listed on IDEAS

    1. Baron, James N & Hannan, Michael T, 1994. "The Impact of Economics on Contemporary Sociology," Journal of Economic Literature, American Economic Association, vol. 32(3), pages 1111-1146, September.
    2. Emery N. Castle, 1998. "A Conceptual Framework for the Study of Rural Places," American Journal of Agricultural Economics, Agricultural and Applied Economics Association, vol. 80(3), pages 621-631.
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