Accidental Logics The Dynamics of Change in the Health Care Arena in the United States, Britain, and Canada

What drives change in health care systems? Why do certain changes occur insome nations and not in others? Author Carolyn Hughes Tuohy argues that theanswer lies in understanding the "accidents" of history that have shapednational systems at critical moments, and in the distinctive "logics" of thesesystems. Tuohy looks at the experiences of Britain, Canada, and the US, offeringan international comparative study of public policy systems, as well as a recenthistory of the circumstances in each country that have impacted on thestructures of each's national health care system. The guiding focus of the bookis Tuohy's study of decision-making systems in each country, looking at thedecisions made by those who provide, finance, and use health care services.Finally, Tuohy reviews current issues in the health care arenas of these threenations and provides suggestions to guide the strategic judgments thatdecision-makers must make.