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

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  • Wilsford, David

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.

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  • Wilsford, David, 1994. "Path Dependency, or Why History Makes It Difficult but Not Impossible to Reform Health Care Systems in a Big Way," Journal of Public Policy, Cambridge University Press, vol. 14(3), pages 251-283, July.
    • Handle: RePEc:cup:jnlpup:v:14:y:1994:i:03:p:251-283_00
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