The Politics and Analytics of Health Policy

Document Type: Editorial


School of Public Policy and Professional Practice, Keele University, UK


Let us start with an example of health policy analysis in action. Within that category of countries loosely known as ‘the West’, quite basic differences exist in attitudes to health policy and also actual health policy. Comparing the US with mainland Europe and indeed Canada, for example, one perceives a difference in attitude on the part of the majority towards collectivism and individualism in access to, provision of and financing of healthcare. The explanation for policy and system differences—for example, between the US healthcare system(s) and the various NHSs of the UK countries (England, Scotland, Wales and Northern Ireland)—is commonly framed in terms of ‘ideology’ but there are also ‘institutional’ explanations (1). Additionally, however, popular attitudes or ‘values’ may be taken as autonomous ‘inputs’ into the explanation (e.g. ‘American values prevent the enactment of an NHS’) or, at least in part, derived from or influenced by institutional reality. If, for example, there is no chance of a bill to establish an NHS or a comprehensive system of public health insurance passing in Washington, then reformers over time trim not only their legislative ambitions, but also their very way of thinking about the issue.


Main Subjects

1.  King A . Ideas, institutions and the policies of governments. Br J Polit Sci1973; 3: 291–313.

2.  Paton CR. U.S. Health Politics: Public Policy and Political Theory. Aldershot and New York: Avebury; 1990.

3.  Moran M. Governing the Healthcare State. Manchester: Manchester University Press; 1999.

4.  Bell D. The End of Ideology. New York: Basic Books; 1960.

5.  Cooper Z, Gibbons S, Jones S, McGuire A. Does hospital competition save lives? Evidence from the English NHS. The Economic Journal2011; 121: F228–60. doi: 10.1111/j.1468-0297.2011.02449.x

6.  Greener I. Unpacking the evidence on competition and outcomes in the English NHS. J Health Serv Res Policy2012; 17: 193–4. doi: 10.1258/jhsrp.2012.012032

7.  Paton CR. The Impact of Market Forces on Health Systems: A Review of Evidence in the 15 European Union Member States. Dublin: European Health Management Association; 2000.

8.  Marmor T. Fads, Fallacies and Foolishness in Medical Care Policy and Management. New Jersey: World Scientific; 2009. doi: 10.1002/hpm.975

9.  Hirschman A. Exit, Voice and Loyalty. Cambridge, Ma: Harvard University Press; 1970. doi: 10.1093/sf/49.3.502-a

10.  Paton   CR.  Visible  hand  or  invisible  fist?  The  new  market  and choice in the English NHS. Health Econ Policy Law2007; 2: 317–25. doi:

11.  Paton CR. New Labour’s State of Health: Political Economy, Public Policy and the NHS. Aldershot: Ashgate; 2006. doi: 10.1002/hpm.877