Healthcare reforms, inertia polarization and group influence
Copyright © 2018 The Authors. Published by Elsevier B.V. All rights reserved..
Healthcare systems performance is the focus of intense policy and media attention in most countries. Quebec (Canada) is no exception, where successive governments have struggled for decades with apparently intractable problems in care accessibility overall, poor performance, and rising costs. This article explores the underlying causes of the disconnection between the high salience of healthcare system dysfunctions in both media and policy debates and the lack of policy change likely to remedy those dysfunctions. Academically, public policies' evolution is usually conceptualized as the product of complex, long-term interactions among diverse groups with specific power sources and preferences. In this context, we wanted to examine empirically whether divergences in stakeholders' views concerning various healthcare reform options could explain why certain policy changes are not implemented despite consensus on their programmatic coherence. The research design was an exploratory sequential design. Data were analyzed narratively as well as graphically using a method derived from social network analysis and graph theory. Results showed striking intergroup convergence around a programmatically sound policy package centred on the general objective of strengthening primary care delivery capacities. Those results, interpreted in light of political science elitist perspectives on the policy process, suggest that the incapacity to reform the system might be explained by one or two groups' having a de facto veto in policy-making.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2018 |
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| Erschienen: |
2018 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:122 |
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| Enthalten in: |
Health policy (Amsterdam, Netherlands) - 122(2018), 9 vom: 07. Sept., Seite 1018-1027 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Contandriopoulos, Damien [VerfasserIn] |
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| Links: |
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| Themen: |
Health policy |
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| Anmerkungen: |
Date Completed 17.01.2019 Date Revised 17.01.2019 published: Print-Electronic Citation Status MEDLINE |
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| doi: |
10.1016/j.healthpol.2018.07.007 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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NLM286719770 |
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| 520 | |a Copyright © 2018 The Authors. Published by Elsevier B.V. All rights reserved. | ||
| 520 | |a Healthcare systems performance is the focus of intense policy and media attention in most countries. Quebec (Canada) is no exception, where successive governments have struggled for decades with apparently intractable problems in care accessibility overall, poor performance, and rising costs. This article explores the underlying causes of the disconnection between the high salience of healthcare system dysfunctions in both media and policy debates and the lack of policy change likely to remedy those dysfunctions. Academically, public policies' evolution is usually conceptualized as the product of complex, long-term interactions among diverse groups with specific power sources and preferences. In this context, we wanted to examine empirically whether divergences in stakeholders' views concerning various healthcare reform options could explain why certain policy changes are not implemented despite consensus on their programmatic coherence. The research design was an exploratory sequential design. Data were analyzed narratively as well as graphically using a method derived from social network analysis and graph theory. Results showed striking intergroup convergence around a programmatically sound policy package centred on the general objective of strengthening primary care delivery capacities. Those results, interpreted in light of political science elitist perspectives on the policy process, suggest that the incapacity to reform the system might be explained by one or two groups' having a de facto veto in policy-making | ||
| 650 | 4 | |a Journal Article | |
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| 650 | 4 | |a Politics | |
| 650 | 4 | |a Quebec (Canada) | |
| 650 | 4 | |a Social network analysis | |
| 700 | 1 | |a Brousselle, Astrid |e verfasserin |4 aut | |
| 700 | 1 | |a Larouche, Catherine |e verfasserin |4 aut | |
| 700 | 1 | |a Breton, Mylaine |e verfasserin |4 aut | |
| 700 | 1 | |a Rivard, Michèle |e verfasserin |4 aut | |
| 700 | 1 | |a Beaulieu, Marie-Dominique |e verfasserin |4 aut | |
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| 700 | 1 | |a Champagne, Geneviève |e verfasserin |4 aut | |
| 700 | 1 | |a Perroux, Mélanie |e verfasserin |4 aut | |
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