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Path Dependency, or Why History Makes It Difficult but Not Impossible to Reform Health Care Systems in a Big Way

Published online by Cambridge University Press:  28 November 2008

David Wilsford
David Wilsford
Affiliation:
Political Scientist, Georgia Institute of Technology
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Abstract

The idea of path-dependency is applied to an examination of health policy reform in Germany, France, Great Britain and the United States. In the path-dependent model, actors are hemmed in by existing institutions and structures that channel them along established policy paths. Therefore, in any system, big (non-incremental) change is unlikely. However, sometimes we do observe big change. Why? By developing the interplay of structure with conjuncture, the occasional accomplishment of big change - in spite of path dependency - can be systematically understood.

Type
Articles
Information
Journal of Public Policy , Volume 14 , Issue 3 , July 1994 , pp. 251 - 283
Copyright
Copyright © Cambridge University Press 1994

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