The Importance of Order and Complements: A New Way to Understand the Dutch and German Health Insurance Reforms
Source
Journal of Health Politics, Policy and Law, 39, 4, (2014), pp. 811-840ISSN
Publication type
Article / Letter to editor

Display more detailsDisplay less details
Organization
Bestuurskunde t/m 2019
Politicologie t/m 2019
Journal title
Journal of Health Politics, Policy and Law
Volume
vol. 39
Issue
iss. 4
Languages used
English (eng)
Page start
p. 811
Page end
p. 840
Subject
Distributional Conflicts in a Globalizing World: Consequences for State-Market-Civil Society ArrangementsAbstract
This article adds to recent theorizing on gradual institutional change by focusing on how institutional displacement occurs through sequential patterns of change. It argues that under certain conditions, reformist political actors may achieve systemic reform through sequences of incremental reforms. We illustrate our argument through a comparative analysis of systemic health care reforms in two Bismarckian health insurance systems, the Netherlands and Germany. These reforms involved further universalization of health care insurance combined with regulated competition to enhance efficiency. The analyses show that reformist actors anticipated institutional drift and that they employed layering and conversion over time to pave the way for institutional displacement. In the Netherlands, successive sequences complemented each other so that over time the former bifurcated insurance system could be replaced by a universal system. In Germany, successive sequences did not complement each other, and bifurcation is still in place.
This item appears in the following Collection(s)
- Academic publications [202923]
- Electronic publications [101091]
- Nijmegen School of Management [12830]
- Open Access publications [69755]
Upload full text
Use your RU credentials (u/z-number and password) to log in with SURFconext to upload a file for processing by the repository team.