The End of an Illusion: The Future of Health Policy in Western Industrialized Nations
Principal contributor and editor (with Jean de Kervasdoué and John Kimberly) Berkeley: University of California Press, 1984.
|In Western industrialized nations, the health sector can no longer continue to grow in the future as it has in the past. The notion that the welfare state can provide an abundance of costly medical services for all its citizens is now widely recognized as an illusion. And policymakers are challenging traditional assumptions, criticizing existing structures, and initiating significant reforms in the health sector.|
|What will the future bring? Can the Western tradition of individualism be reconciled with the principle of equity in health policy? Will it be possible to continue to remunerate the growing number of physicians at the level to which they have become accustomed? Will it be feasible to encourage new medical technologies, support the biomedical industry, and at the same time contain the growth of health care costs and achieve more equitable access to services? What are alternative roles for the state in coping with issues of public policy?|
|In addressing these questions, Kervasdoue, Kimberly, and Rodwin have edited and contributed to an original collection of essays and case studies on the forces that are transforming health care systems in the West. They begin by identifying issues around which debates about health policy will focus in the 1980s and beyond. These are: (1) the contrasting perspectives on the role of the state in society; (2) the place of disease prevention and health promotion in health policy; (3) the development and consequences of new medical technology; and (4) the ethical challenge of health care rationing. These issues are reflected in the other essays in the book-all by knowledgeable scholars from different disciplines and of varying political persuasions-to provide a fascinating comparative view of health systems.|
|At the heart of the book is its four case studies on the recent past and probable future of health policy in France, Britain, the United States, and the Canadian province of Quebec. And in the final chapter, John Kimberly and Victor Rodwin distinguish some common themes-as well as some variations-that emerge from the case studies and also speculate about the new constraints and choices that will characterize the future of health policy. Coming at a crucial time, The End of Illusion examines the forces that are transforming health care systems in the Western industrialized nations, and identifies the issues and themes on which debates about health policy will focus in the 1980s and beyond.|