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Association: Name: American Political Science Association URL: http://www.apsanet.org
Citation: URL: http://www.allacademic.com/meta/p210789_index.html Direct Link: HTML Code:

Hasselmann, Chris. and Park, David. "Thatcher and the National Health Service: Belief Cascades, Heresthetics, and Institutional Change" Paper presented at the annual meeting of the American Political Science Association, Hyatt Regency Chicago and the Sheraton Chicago Hotel and Towers, Chicago, IL, Aug 30, 2007 <Not Available>. 2011-06-09 <http://www.allacademic.com/meta/p210789_index.html>

Hasselmann, C. and Park, D. K. , 2007-08-30 "Thatcher and the National Health Service: Belief Cascades, Heresthetics, and Institutional Change" Paper presented at the annual meeting of the American Political Science Association, Hyatt Regency Chicago and the Sheraton Chicago Hotel and Towers, Chicago, IL Online <APPLICATION/PDF>. 2011-06-09 from http://www.allacademic.com/meta/p210789_index.html

Publication Type: Conference Paper/Unpublished Manuscript Abstract: Why is health care reform so difficult politically? One prominent explanation holds that �it�s the institutions, stupid!� What then can the literature on institutional change tell us about health care reform? Drawing on the notion of belief cascades, we argue that various crises in the health care can challenge the beliefs that support and maintain a given institutional arrangement, and that the resulting quandary creates the possibility of triggering a belief cascade that results in institutional change. We demonstrate how the advent of long waiting lists within the British National Health Service (NHS) created just such a quandary about a system that was widely supported while at the same time widely criticized in regards to its provision of service. We further show how Thatcher was able to engage in a heresthetical maneuver that depicted the waitlists as resulting from inefficiencies within the NHS, and not a lack of resources (e.g., insufficient money, physicians, nurses, or hospitals). In doing so, she was able to trigger a belief cascade that supported the introduction of a previously unviable feature, namely an internal market within the NHS. We also show that the advent of the waitlists did not directly challenge the strongly held belief that the NHS should remain public, and therefore did not allow for the complete privatization of the Service as some had hoped. We generalize our findings by arguing that such crises and quandaries are likely to emerge in the near future as the baby-boomers age, putting increases pressure on already strained health care systems.

Health Care Reform, Public Health and Institutional Change

Evaluating Grand Claims in Oregon Health Care Reform via the Health Services Commission: Deliberative Democracy or ‘Normal Politics?’