Who Governs the Health Sector? Comparative European and American Experiences with Representation, Participation, and Decentralization

Abstract

With health care a major component of the contemporary welfare state, arrangements for planning, financing, operating, and evaluating health services have become political issues throughout the industrialized western world. The range, provision, and utilization of health services are influenced by the activities of interest groups and professional associations, competition among rival ideologies, and partisan appeals for electoral support. But in the end, there remains the constant struggle to win control over decision-making. From a physician's examining room to legislative chambers, and from hospital corridors to administrative offices, questions of health care reveal the drama of human beings attempting to use