Specific Detail Info |
Path
dependence, a model first advanced to explain puzzles in the diffusion
of technology, has lately won allegiance among analysts of the politics of public
policy, including health care policy. Though the central premise of the model—that
past events and decisions shape options for innovation in the present and future—is
indisputable (indeed path dependence is, so to speak, too shallow to be false), the
approach, at least as applied to health policy, suffers from ambiguities that undercut
its claims to illuminate policy projects such as managed care, on which this article
focuses. Because path dependence adds little more than marginal value to familiar
images of the politics of policy—incrementalism, for one—analysts might do well
to put it on the back burner and pursue instead “thick descriptions” that help them to
distinguish different degrees of openness to exogenous change among diverse policy
arenas. |