Abstract
The industrialised democracies of the world confront a complex dilemma. A seemingly insatiable demand for health care is outstripping supply, despite a relentless increase in the latter’s share of national budgets and family incomes. Yet there is little corresponding rise in general health indices, or even in human happiness about the quality of medical services. The inability of health services to deliver greater health for more money has ironically not blunted the public’s appetite for them; rather it has perversely increased it. Among the evident reasons for this paradox are that affluent humanity is less prepared than ever before to suffer minor ailments without drugs or other medical help; that demand for health care has been further stimulated both by new treatments for curable diseases and by expanded coverage throughout the poorer levels of society; that new cures for old diseases come with ever higher price tags for their sophisticated technology, so that much additional spending still saves few lives; and that the elderly, whose relative numbers in society are growing, require more routine medical care than the young. Clearly health services in the developed North are victims of their own successes.
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Bibliography
Alford, R.R. (1975) Health Care Politics: Ideological and Interest Group Barriers to Reform (University of Chicago Press).
Altenstetter, C. (1974) Health Policy Making and Administration in West Germany and the United States (Beverly Hills, California: Sage Publications).
Altenstetter, C. (1980) ‘Hospital Planning in France and the Federal Republic of Germany’, Journal of Health Politics, Policy and Law, no. 5, pp. 309–32.
Altenstetter, C. and J.W. Björkman, (1983) Federal-State Health Policies and Impacts: The Politics of Implementation (Washington, DC: University Press of America, 1978).
Altenstetter, C. and J.W. Björkman, ‘Planning and Implementation: A Comparative Perspective on Health Policy’, International Political Science Review, no. 13, pp. 73–91.
Aluwihare, A.P.R. (1982) ‘Traditional and Western Medicine Working in Tandem’. World Health Forum. vol. 3. no. 4. pp. 450–1.
Ameline, C.E. (1984) ‘Philosophy and Cost of Health Care in France’, in Virgo, loc. cit., pp. 17–29.
Anderson, O.W. (1972) Health Care: Can There Be Equity? The United States, Sweden, and England (New York: John Wiley and Sons).
Anderson, O.W. and J.W. Björkman, (1980) ‘Equity and Health Services: Sweden, Britain, and the United States’, in Heidenheimer and Elvander, loc. cit., pp. 223–37.
Ashford, D. (ed.) (1980) Comparative Public Policies: New Concepts and Methods (Beverly Hills, California: Sage Publications).
Banerji, D. (1972) ‘Social and Cultural Foundations of Health Services Systems’, Economic and Political Weekly (Special August Number) pp. 1333–45.
Barnard, K. and K. Lee (eds) (1977) Conflicts in the National Health Service (London: Croom Helm).
Bausell, R.B. and A.J. Rinkus, (1979) ‘A Comparison of Written Versus Oral Interviews’. Evaluation and the Health Professions, vol. 2, no. 4, pp. 477–86.
Berki, S.S. (1985) ‘DRGs, Incentives, Hospitals, and Physicians’, Health Affairs, vol. 4. no. 4. pp. 70–76.
Berlant, J.L. (1975) Profession and Monopoly: A Study of Medicine in the United States and Great Britain (Berkeley: University of California Press).
Björkman, J.W. (1977) ‘Political-Administrative Relationships in Development: Contributions and Constraints’, in Sharma, loc. cit., pp. 601–616.
Björkman, J.W. (1979) The Politics of Administrative Alienation (Delhi: Aianta Publications).
Björkman, J.W. (1982) ‘Professionalism in the Welfare State: Sociological Saviour or Political Pariah?’ European Journal of Political Research, no. 10, pp. 407–28.
Björkman, J.W. (1984) ‘Health Policy and Politics in Sri Lanka: Developments in the South Asian Welfare State’. Asian Survey, vol. 34, no. 5, pp. 211–40.
Björkman, J.W. (1985) ‘Who Governs the Health Sector? Comparative European and American Experiences with Representation, Participation and Decentralisation’, Comparative Politics, no. 17, pp. 399–420.
Björkman, J.W. (ed.) (1986) The Changing Division of Labour in South Asia: Women and Men in Politics, Economics, Society (Riverdale, Maryland: The Riverdale Company).
Björkman, J.W. (1987) ‘Health Policies and Human Capital: The Case of Pakistan’, Pakistan Development Review, no. 11, pp. 411–30.
Björkman, J.W. (ed.), (1988) Fundamentalism, Revivalists, and Violence in South Asia (New Delhi: Manohar Publishers).
Björkman, J.W. (1989) ‘Politicising Medicine and Medicalising Politics: Physician Power in the United States’, in Freddi and Björkman, loc. cit., pp. 28–73.
Björkman, J.W. and C. Altenstetter, (1979) ‘Accountability in Health Care: An Essay on Mechanisms, Muddles, and Mires’, Journal of Health Politics, Policy, and Law, no. 4, pp. 360–81.
Björkman, J.W. and B.W. Coyer, (1980) ‘Comparative Policy Research and Discriminant Function Analysis’, Political Change (Jaipur, India) no. 3, pp. 26–46.
Björkman, J.W. and G.A. Silver (1978) ‘Citizen Control of Health Services: An International Perspective on Participation, Representation, and Social Policy’, Proceedings of the Ninth World Congress of Sociology (Uppsala, Sweden, 12–19 August).
Bornstein, S. et al. (eds), (1984) The State in Capitalist Europe (London: Allen and Unwin).
Brown, L.D. (1982) The Political Structure of the Federal Health Planning Program (Washington, DC: The Brookings Institution)
Carder, M. and B. Klingeberg, (1980) ‘Towards a Salaried Medical Profession? How “Swedish” Was the Seven Crowns Reform?’, in Heidenheimer and Elvander. loc. cit.. pp. 143–72.
Charles, C.A. (1976) ‘The Medical Profession and Health Insurance: An Ontario Case Study’, Social Science and Medicine no. 10. pp. 33–8.
Cleverly, W. (ed), (1982) Handbook of Health Care Accounting and Finance (Maryland: Aspen Publishing).
Cochrane, A.C. (1972) Effective Uses and Efficiency: Random Reflections on Health Services (London: The Nuffield Provincial Hospitals Trust).
Cohen, S.S. and C. Goldfinger, (1975) ‘From Permacrisis to Real Crisis in French Social Security: The Limits to Normal Politics’, in Lindberg et al., loc. cit., pp. 57–98
Commonwealth Secretariat, (1982) The Contribution of Medical Schools to National Health Development (Report of a Commonwealth Workshop at Kandy, Sri Lanka) (London: Marlborough House).
Derber, C. (ed.), (1982) Professionals as Workers: Mental Labour in Advanced Capitalism (Boston: G.K. Hall).
Derber, C. (1983) ‘Sponsership and Control of Physicians’, Theory and Society, no. 12. pp. 561–601.
Döhler, M. (1989) ‘Physicians’ Professional Autonomy in the Welfare State: Endangered or Preserved?’, in Freddi and Björkman, loc. cit., pp. 178— 97.
Dudley, A. (1984) ‘The DRG Tug-of-War’, Medicine and Computers (September–October) pp. 34–7.
Ehrenreich, J. (ed.), (1978) The Cultural Crisis of Modern Medicine, (New York: Evergreen Press).
Elling, R.H. (1980) Cross-National Study of Health Services: Political Economies and Health Care, (New Brunswick, New Jersey: Transaction Books).
Elston, M.A. (1977) ‘Medical Autonomy: Challenges and Responses’, in Barnard and Lee. op. cit.. pp. 26–51.
Evans, J.R., K. Hall and J. Warford, (1981) ‘Health Care in the Developing World: Problems of Scarcity and Choice’, New England Journal of Medicine, no. 305, pp. 1117–27.
Field, M.G. (1980) ‘The Health System and the Polity: A Contemporary American Dialectic’, Social Science and Medicine, no. 14A, pp. 397–413.
Franda, M. (1983) Voluntary Associations and Local Development in India (New Delhi: Young Asia Publications).
Frazier, H.S. and H.H. Hiatt, (1978) ‘Evaluation of Medical Practices’, Science, no. 200, pp. 875–8.
Freddi, G. and J.W. Björkman (eds) (1898) Controlling Medical Professionals: The Comparative Politics of Health Policies (London: Sage Publica-tions).
Freidson, E. (1970) Professional Dominance (Chicago: Aldine Publishing Company).
Freidson, E. (1975) The Profession of Medicine: A Study of the Sociology of Applied Knowledge (New York: Dodd, Mead and Company).
Freidson, E. (1985) ‘Reorganisation of the Medical Profession’, Medical Care Review, no. 42, pp. 11–35.
Fuchs, V.R. (1974) Who Shall Live? Health, Economics, and Social Choice (New York: Basic Books. Inc.).
Fuchs, V.R. (1981) ‘The Coming Challenge to American Physicians’, New England Journal of Medicine, no. 304, pp. 1487–90.
Fuchs, V.R. (1982) ‘The Battle for Control of Health Care’, Health Affairs, vol. 1, no. 2, pp. 5–13.
Giddens, A. and G. Mackenzie (eds), (1982) Social Class and the Division of Labour (Cambridge: Cambridge University Press).
Glaser, W.A. (1978) Health Insurance Bargaining: Foreign Lessons for Americans (New York: Gardner Press).
Godt, P.J. (1984) ‘Doctors and Deficits:’ Regulating the Medical Profession in France’, Proceedings of the annual meeting of the American Political Science Association (Washington, DC: September).
Golladay, F. and B. Liese, (1980) Health Problems and Policies in the Developing Countries (Washington, DC: The World Bank).
Goodman, J.C. (1980) The Regulation of Medical Care: Is the Price Too High? (San Francisco: Cato Institute).
Grant, J.P. (1976) ‘A Fresh Approach to Meeting Basic Human Needs of the World’s Poorest Billion: Implications of the Chinese and Other “Success” Models’, Proceedings of the annual meeting of the American Political Science Association (Chicago: 2–4 September).
Gray, B. (ed.), (1983) New Health Care for Profit (Washington, DC: National Academy Press).
Harrison, S. and R.I. Schulz, (1989) ‘Clinical Autonomy in Britain and the United States: Contrasts and Convergences’, in Freddi and Björkman, op. cit., pp. 198–209.
Heidenheimer, A.J. (1980) ‘Conflicts and Compromises Between Professional and Bureaucratic Health Interests, 1947–1972’, in Heidenheimer and Elvander, loc. cit., pp. 119–42.
Heidenheimer, A.J. and N. Elvander (eds), (1980) The Shaping of the Swedish Health System (London: Croom Helm).
Heller, T. (1978) Restructuring the Health Service (London: Croom Helm).
Herzlich, C. (1982) ‘The Evolution of Relations Between French Physicians and the State from 1880 to 1980’, Sociology of Health and Illness, no. 4, pp. 241–53.
Hessler, R.M. and A.C. Twaddle, (1982) ‘Sweden’s Crisis in Medical Care: Political and Legal Changes’, Journal of Health Politics, Policy, and Law, no. 7, pp. 440–59.
Horowitz, I.L. (1965) The Three Worlds of Development, (New Brunswick, New Jersey: Transaction Books).
Howard, L.M. (1981) ‘What Are the Financial Resources for “Health 2000?”’. World Health Forum. vol. 2. no. 1. pp. 23–9.
Hunt, K. (1983) ‘DRG — What It Is, How It Works, and Why It Will Hurt’, Medical Economics, 5 September pp. 264–5.
Illich, I. (1973) Medical Nemesis (Boston: Beacon Press).
Jaggi, O.P. (1976) All About Allopathy, Homeopathy, Ayurveda, Unani, and Nature Cure (New Delhi: Orient Paperbacks).
Jacques, E. (ed.), (1978) Health Services: Their Nature and Organisation and the Role of Patients, Doctors, Nurses, and the Complementary Professions (London: Heinemann).
Jeffrey, R. (1976) ‘Health Care Delivery System: A Comment’, Economic and Political Weekly (10 July) pp. 1046–7.
Johnson, R. (1982) ‘The State and the Professions: Peculiarities of the British’, in Giddins and Mackenzie, op. cit. , pp. 186–208.
Kearney, R.N. (1973) The Politics of Ceylon (Sri Lanka), (Ithaca, New York: Cornell University Press).
Kelman, S. (1977) ‘The Social Basis of the Definition of Health’, Internatio-nal Journal of Health Services, no. 6. pp. 217–47.
Klein, R. (1977) ‘The Corporate State, Health Service, and the Professions’, New University Quarterly no. 31 pp 161–80
Klein, R. (1983) The Politics of the National Health Service (London: Longmans).
Klein, R. and J. Lewis, (1976) The Politics of Consumer Representation (London: Centre for Studies in Social Policy).
Kohn, R. and K.L. White (eds), (1976) Health Care: An International Study (London: Oxford University Press).
Krause, E. (1977) Power and Illness: The Political Sociology of Medical Care (New York: Elsevier).
Lagergren, M. and K.E. Wictorsson, (1977) Case Study on Health Planning Organisation and Process in Sweden (Stockholm: Sjukvårdens och Social-vårdens Planerings och Rationaliserings Institut).
Lebish, D.J. (1982) ‘PSROs and Utilisation Review: Life, Death, and Rebirth’, in Cleverly. op. cit.
Leichter, H. (1979) A Comparative Approach to Policy Analysis: Health Care Policy in Four Nations (New York: Cambridge University Press).
Leslie, C. (ed.) (1976) Asian Medical Systems: A Comparative Study (Berkeley: University of California Press).
Levitt, R. (1977) The Reorganised National Health Service, 2nd edition (London: Croom Helm).
Lindberg, L. et al. (eds), (1975) Stress and Contradiction in Modern Capitalism (Lexington, Massachusetts: Lexington Books).
Luft, H.D. (1983) ‘Economic Incentives and Clinical Decisions’, in Gray, op. cit., pp. 103–23.
McKinlay, J.B. (1982) ‘Toward the Proletarianisation of Physicians’, in Derber op. cit.. pp. 37–65.
McLachlan, G. and A. Maynard (eds) (1982) The Public/Private Mix for Health (London: Nuffield Provincial Hospitals Trust)
Mahler, H. (1977) ‘Blueprint for Health for All’, WHO Chronical, no. 31, pp. 491–8.
Marmor, T.R. (1973) The Politics of Medicare (Chicago: Aldine Publishing Company).
Marmor, T.R., (1980) A. Bridges and W. Hoffman, ‘Comparative Politics and Health Policies: Notes on Benefits, Costs, Limits’, in Ashford, op. cit., pp. 59–80.
Marmor, T.R. and J.A. Morone, (1980) ‘Representing Consumer Interests: Imbalanced Markets, Health Planning, and the HSAs’, Health and Society: Milbank Memorial Fund Quarterly, no. 58, pp. 125–65.
Marmor, T.R. and D. Thomas, (1972) ‘Doctors, Politics, and Pay Disputes: “Pressure Group Politics” Revisited’, British Journal of Political Science, no. 2. pp. 422–42.
Maxwell, R. (1975) Health Care: The Growing Dilemma: Needs v. Resources in Western Europe, the US, and the USSR, 2nd edition (New York: McKinsey).
Maxwell, R. (1981) Health and Wealth: An International Study of Health Care Spending, (Lexington, Massachusetts: Lexington Books).
Mechanic, D. (1976) The Growth of Bureaucratic Medicine (New York: John Wiley and Sons).
Mechanic, D. (1984) ‘The Transformation of Health Providers’, Health Affairs, no. 4, pp. 65 – 74.
Morone, J.A. and A.B. Dunham, (1984) ‘DRGs and the Waning of Professional Dominance’, Health Affairs, no. 3, pp. 73–86.
Mosher, F. (1978) ‘Professions in Public Service’, Public Administration Review no 38, pp. 144–50.
Moskop, J.C. (1981) ‘The Nature and Limits of the Physicians’ Authority’, in Staum and Larson, loc. cit., pp. 29–43.
Nayar, B.R. (1972) The Modernisation Imperative (New Delhi: Vikas Publications).
Niessen, M. and J. Peschar (eds), (1982) International Comparative Research: Problems of Theory, Methodology, and Organisation in Eastern and Western Europe (Oxford: Pergamon Press, Ltd.).
Poullier, J.J. (ed.) (1977) Public Expenditures on Health (Paris: OECD Studies in Resource Allocation, no. 4,).
Przeworski, A. and H. Teune, (1970) The Logic of Comparative Social Inquiry (New York: Wiley-Interscience, John Wiley and Sons).
Robson, J. (1973) ‘The NHS Company, Inc.? The Social Consequences of Professional Dominance in the National Health Service’, International Journal of Health Services, no. 3, pp. 413–26.
Rodwin, V.G. (1981) ‘The Marriage of National Health Insurance and “La Médicine Libérale” in France: A Costly Union’, Health and Society: Milbank Memorial Quarterly no. 59, pp. 16–43.
Rodwin, V.G. (1982) ‘Management Without Objectives: The French Health Policy Gamble’, in McLachlan and Maynard, op. cit.. pp. 289–325.
Sharma, S.K. (ed.) (1977) Dynamics of Development: An International Perspective (New Delhi: Concept Publishing Company).
Shenkin, B.N. (1973) ‘Politics and Medical Care in Sweden: The Seven Crowns Reform’ New England Journal of Medicine no. 288, pp. 555–9.
Sidel, R. and V.W. Sidel, (1982) The Health of China: Current Conflicts in Medical and Human Services for One Billion People (Boston: Beacon Press).
Silver, G.A. (1976) et al., Impact of Federal Health Policies in the States of Connecticut and Vermont (Springfield, Virginia: National Technical Information Service) (PB-262–959).
Silvard, R.L. (1979) World Military and Social Expenditures 1979 (Leesburg, Virginia: World Priorities).
Silvard, R.L. (1982) World Military and Social Expenditures 1982 , (Leesburg, Virginia: World Priorities)
Silvard, R.L. (1986) World Military and Social Expenditures 1986, (Leesburg, Virginia: World Priorities).
Starr, P. (1982) The Social Transformation of American Medicine (New York: Basic Books).
Staum, M.S. and D.E. Larson (eds), (1981) Doctors, Patients, and Society, (Waterloo, Ontario: Wilfried Laurier University Press).
Steffen, M. (1983) ‘Régulation Politique et Stratégiés Professionnelles: Médicine Libérale et Emergence des Centres de Santé’ (Grénoble: manuscript).
Steudler, F. (1977) ‘Médicine Libérale et Conventionnement’, Sociologie du Travail, no. 17. pp. 176–98.
Steudler, F. (1984) ‘State and Health in France’ (Paris: manuscript).
Stone, D.A. (1980) The Limits of Professional Power: National Health Insurance in the Federal Republic of Germany (Chicago: University of Chicago Press).
Szalai, A. and R. Petrella (eds), (1977) Cross-National Comparative Survey Research: Theory and Practice (Oxford: Pergamon Press. Ltd.).
Taylor, R.C.R. (1984) ‘State Intervention in Postwar Western European Health Care: The Case of Prevention in Britain and Italy’, in Bornstein et al., op. cit., pp. 91–117.
Tolliday, H. (1978) ‘Clinical Autonomy’, in Jacques, op. cit., pp. 32–52.
Virgo, J.M. (ed.) (1984) Health Care: An International Perspective (Edward-sville, Illinois: International Health Economics and Management Institute).
Walt, G. and P. Vaughn, (1981) An Introduction to the Primary Health Care Approach in Developing Countries (London: Ross Institute of Tropical Hygiene).
Weller, G. and P. Manga, (1983) ‘The Push for Reprivatisation of Health Care Services in Canada, Britain, and the United States’, Journal of Health Politics, Policy, and Law, no. 8, pp. 495–518.
Wiatr, J. (1977) ‘The Role of Theory in the Process of Cross-National Survey Research’, in Szalai and Petrella, op. cit., pp. 347–72.
Wilsford, D. (1989) ‘Physicians and the State in France’, in Freddi and Björkman, op. cit., pp. 130–56.
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Björkman, J.W. (1991). Conclusion: Grains Among the Chaff — Rhetoric and Reality in Comparative Health Policy. In: Altenstetter, C., Haywood, S.C. (eds) Comparative Health Policy and the New Right. Palgrave Macmillan, London. https://doi.org/10.1007/978-1-349-11777-2_11
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