Healthy or Sick?

Healthy or Sick?

Coevolution of Health Care and Public Health in a Comparative Perspective

Trein, Philipp (Universite de Lausanne, Switzerland)

Cambridge University Press






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Analyses the relation of preventive and curative health policy and its evolution over time.
1. Introduction; 1.1. Concepts and theoretical priors in brief; 1.1.1. Concepts; 1.1.2. Theoretical priors and research design; 1.2. Main results; 1.3. Lessons from this research for the political science and health policy literature; 1.3.1. Health care and public health; 1.3.2. Professional activism and institutional evolution; 1.3.3. Policy integration, coupling and coevolution of policy sectors; 1.4. Outline for the book; 2. Sectoral coupling of health care and public health; 2.1. Health care and public health as two different policy sectors; 2.1.1. Health care; 2.1.2. Public health; 2.2. Horizontal relations of policy sectors; 2.3. Summary; 3. Theoretical priors; 3.1. The argument in general terms; 3.1.1. Prelude: standard institutional analysis; 3.1.2. Professionalism and interest group inclusion; 3.1.3. Unified government; 3.1.4. Contextual elements; 3.2. Implications for health care and public health; 3.2.1. Standard institutional analysis and the coevolution of health care and public health; 3.2.2. Professions, interest group inclusion, and the relation of health care and public health; 3.2.3. Unified government in health care and public health; 3.2.4. Contextual elements in health care and public health; 3.3. Summary; 4. Global context and case selection; 4.1. Emergence of health care and public health as two policy sectors (1880-1918); 4.2. The turn towards individual health care (1918-1945); 4.3. Dominance of medical care and marginalization of public health (1945-1975); 4.4. The long return of public health (1974-2010); 4.5. Implications for the country studies; 4.6. Case selection for country studies; 4.7. Data, operationalization and method; 4.8. Discussion and summary of the approach; 5. UK: institutional unification and tight coupling of health care and public health; 5.1. Origins of public health policy (1850-1918); 5.1.1. Unification of both sectors in national public health legislation; 5.1.2. Responsiveness of actors from both sectors; 5.2. Cooperation and conflict in the interwar period (1918-1945); 5.2.1. Towards more institutional unification; 5.2.2. Professional conflicts but unification of public services; 5.3. Towards responsiveness in the shadow of the NHS (1945-1980); 5.3.1. Institutional unification through the NHS; 5.3.2. Conflicts and cooperation between actors from both sectors; 5.4. Towards further unification between health care and public health (1980-2010); 5.4.1. Remaining institutional unification despite delegation and liberalization; 5.4.2. Policy instead of professional responsiveness; 5.5. Discussion; 5.5.1. Unified government and professionalism in the UK; 5.5.2. Competing explanations; 5.6. Conclusion; 6. Australia: politicized professions and tight coupling of health care and public health; 6.1. Loose coupling in times of sectorial emergence (1850-1918); 6.1.1. Differentiation in colonial times; 6.1.2. Actor responsiveness between the two sectors; 6.2. Nation building and the unification of health care and public health (1918-1945); 6.2.1. Towards institutional unification; 6.2.2. Conicts and responsiveness during the interwar period; 6.3. Dominance of medical care in the shadow of tight coupling (1945-1980); 6.3.1. Post war coevolution of institutional relations; 6.4. Tight coupling of health care and public health (1980-2010); 6.4.1. Consolidating unification and re-separation; 6.4.2. Broad responsiveness and policy integration; 6.5. Discussion; 6.5.1. Unified government, professionalism, and interest intermediation in Australia; 6.5.2. Competing explanations; 6.6. Summary; 7. Germany: dominance of individual health care and de-coupling from public health; 7.1. Local public health in the shadow of the national health insurance (1880-1918); 7.1.1. Institutional distinctiveness on three levels of government; 7.1.2. Professional differentiation and political inclusion of doct
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