Ellen M. Immergut. Health Politics, Interests and
Institutions in Western EuropeNew York: Cambridge University Press,
1992. xxiii+336 pp. $49.95. |
| Ellen Immergut has produced a first-rate scholarly study about
how political institutions have affected health policies in France,
Switzerland and Sweden. This book is timely for readers in the United
States because it provides a comparative analysis of the evolution and
politics of national health insurance (NHI). The main argument is that
although the policy issues and interest groups affected by the passage of
NHI bear a striking resemblance in France, Switzerland and Sweden, the
evolution and outcomes of the process were very different due to the
institutional design of the decision-making process in each country. |
| All efforts to create a system of national health insurance have
involved conflict between government as buyer and regulator of
health services, and providers who resist the imposition of price
controls and other forms of government intervention into their affairs.
Immergut shows, through carefully crafted case studies, that the goals
of policymakers and interest groups were quite similar in France,
Switzerland and Sweden, and she suggests that the different outcomes
reflect not so much different ideologies, or patterns of interest group
demands, but rather differences in political institutions for decision-making. |
| In France, the significant change in these institutions following
the creation of the Fifth Republic in 1958 provides for a particularly
rich case study. Immergut highlights the contrast in health politics
between a parliamentary system with weak coalitions and a maze of
interest groups and veto points before 1958, and a new constitution
allowing for a powerful president following 1958. In Switzerland,
the use or even the threat of national as well as local referenda
has succeeded in constraining the role of the federal government
in health care, and blocking successive attempts at the creation
of compulsory national health insurance even after decisions had
been made in the executive branch and approved by parliament. Finally,
in Sweden, a strong executive branch in combination with a tradition of
party loyalty and consensual agreements among major interest groups
limited opportunities for parliamentary opposition and thereby enabled
the establishment of NHI, controls on doctors' fees, and finally the
creation of a national health service. |
| As a contribution to scholarship in political science, Health Politics
contains useful first and last chapters on the role of interests, class
and institutions in the making of health policy. As a contribution to
health policy, Health Politics leaves us with three excellent case
studies on the evolution of national health insurance in France,
Switzerland and Sweden. France and Switzerland, in particular, have
received almost no attention from policy analysts who seek to inform
American policymakers in the current debates about health care reform.
This is unfortunate because both systems have virtually universal
coverage, private fee-for-service practice, high rates of patient
satisfaction, and some of the highest-quality medical care in the
world. Moreover, both systems provide a rich source of lessons for
policymakers in the United States. |
| French NHI, like German and Japanese NHI, is an important model
of a system financed on the basis of employer mandates (compulsory
payroll taxes and direct premiums for agricultural workers and the
self-employed) with no restrictions on what providers a patient may
consult and virtually no restrictions on how physicians should practice
their profession (I). The case study reveals how long it took to expand
the initial legislation in 1928 and how powerful interest groups such as
doctors and small business succeeded in constraining legislation and
slowing its implementation. The Swiss health insurance system provides
a model of what some market reform proposals in the U.S. might lead to
in the best of all possible worlds! Since the Swiss system is federal,
highly decentralized, and highly restrictive of government intervention,
it is an important model for what many Americans cherish. The
system of government subsidies to mutual funds and public hospitals
results in almost universal coverage on a voluntary basis. |
| Beyond the significant contributions of the book, there are
three regrettable gaps. First, the curious reader cannot help
but wonder what insights Immergut's institutional analysis would
yield about other important health system models, e.g. Britain,
Canada, Germany and Japan. Second, the case studies make no inferences
about the likely course of health care reform in France, Switzerland and
Sweden. This is a pity because all three countries are contending with
different reform proposals. The French stalemate is reminiscent of the
pre - 1958 period so well analyzed by Immergut. The rising costs in
Switzerland are pushing the federal government to act but the obstacles
remain enormous. And the Swedish demands for improving accountability
to consumers appears to be leading to innovative forms of decentralized
"public competition" (2). How will political institutions mediate the
current process of health care reform? Unfortunately, Immergut is
silent on this important question. |
| Finally, it is regrettable that Health Politics pays so little
attention to the evolution and politics of health care reform in
the United States. In light of the failure of the Clinton plan or
any other widereaching reform proposal - be it the single payer or
managed competition strategy?how much is due to the design of our
political institutions - Recent writings on American health politics
have emphasized how the new politics has enabled important reforms
through a kind of "technocratic corporatism" (3). But the past year
of health care reform seems, in many respects, to have brought us
back to the old politics of Medicare so well analyzed by Ted Marmor
(4). The "disjointed incrementalism" of Charles Lindblom seems more
relevant than ever in understanding contemporary health politics (5).
For this reason alone, however brief her discussion of the United States,
Ellen Immergut's comparative analysis of political institutions and their
impact on health politics is essential reading for all those who wish to
understand the limits and possibilities for health care reform here at
home. |
REFERENCES
- Fielding, J. and Lancry, J. "Lessons from France Wive la Difference'.
The French Health Care System and US Health System Reform," JAMA 270 (1992):
748-56; Rodwin, V. and Sandier, S. "Health Care under French National
Health Insurance," Health Affairs, Fall, 1993.
- Saltman, R. "Recent Health Policy Initiatives in Nordic Countries,"
Health Care Financing Review 13 (4, Summer 1992): 157-66.
- See, e.g., Brown, L. "Technocratic Corporatism and Administrative
Reform in Medicare," JHPPL 10 (3), Fall 1995; Smith, D. Paying for
Medicare. New York: Aldine de Gruyter, 1992.
- Marmor, T. The Politics of Medicare. New York: Aldine de Gruyter, 1970.
- Lindblom, C. "The Science of Muddling Through," Public Administrative
Review, 19 (1959): 79-88.
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