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A Socio-instutionalist Critique of the 1990s' Reforms of the United Kingdom's National Health Service
Authors:Robert McMaster
Institution:Georgetown University
Abstract:This paper argues that the on-going reforms to the UK's National Health Service initiated in the 1990s represent potentially profound institutional change to the values underpinning the process of care. The market-orientation of the reforms is highlighted, and it is asserted that the theoretical rationale for this is informed by the nascent neoclassical health economics and new institutionalist literatures, which exhibit utilitarian propensities in that both stress outcomes and at best relegate process. Drawing from the seminal contribution of Thorstein Veblen, the paper argues that market-oriented reform in the UK may induce a shift from a Hippocratic ethos to a more individualistic value system.
Keywords:Institutional Change  Neoclassical Health Economics  Reform  Utilitarianism
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