This three-part article presents an analysis of the distribution of power and of the nature of the state in Western industrialized societies, and details their implications in medicine. Part I presents a critique of contemporary theories of the Western system of power; discusses the countervailing pluralist and power elite theories, as well as those of bureaucratic and professional control; and concludes with an examination of the Marxist theories of economic determinism, structural determinism, and corporate statism. Part II presents a Marxist theory of the role, nature, and characteristics of state intervention. Part III focuses on the mode of that intervention and the reasons for its growth, with an added analysis of the attributes of state intervention in the health sector and of the dialectical relationship between its growth and the current fiscal crisis of the state. In all three parts, the focus is on Western European countries and on North America, with many examples and categories drawn from the area of medicine.
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References
1.
CochraneA. L.Effectiveness and Efficiency. Nuffield Provincial Hospitals Trust, London, 1972.
2.
TitmussR.Commitment to Welfare. Unwin University Books, London, 1968.
3.
HartTudor J.The inverse care law. Lancet1: 405–412, February 27, 1971.
4.
BiceT. W.EichhornR. L., and FoxP. D.Socioeconomic status and use of physician services. Med. Care10(3): 261–271, 1972.
5.
BerkiS. E.Comments on “Socioeconomic status and use of physician services.”Med. Care11(3): 259, 1973.
6.
AndersonO.Health Care: Can There Be Equity?John Wiley and Sons, New York, 1972.
7.
WestergaardJ. H.Sociology: The myth of classlessness. In Ideology in Social Science, edited by BlackburnR., pp. 119–163. Random House, New York, 1973.
8.
HabermasJ.Toward a Rational Society. Beacon Press, Boston, 1971.
MarxK., and EngelsF.The Communist Manifesto. International Publishers, New York, 1960.
46.
GoughI.Review of The Fiscal Crisis of the State. Bulletin of the Conference of Socialist Economists4(1): 823, 1975.
47.
MandelE.Late Capitalism. New Left Books, London, 1975.
48.
OffeC.The theory of the capitalist state and the problem of policy formation. In Stress and Contradiction in Modern Capitalism, edited by LindbergL., pp. 125–144. Lexington Books, London, 1975.
49.
SigeristH. E.Landmarks in the History of Hygiene. Oxford University Press, London, 1956.
50.
GeorgeV., and WildingP.Social values, social class and social policy. Social and Economic Administration6: 236–248, September 1972.
51.
LaswellH. D.The Comparative Study of Elites. Stanford University Press, Stanford, 1952.
52.
MillsC. W.The Power Elite. Oxford University Press, New York, 1956.
53.
GuttsmanW. L.The British Political Elite. MacGibbon and Kee, London, 1963.
54.
KilbornP. K.Britain slashes spending on social welfare items. New York Times, February 21, 1976.
55.
The budget.Special issue of the National Journal, Volume 8, Number 5, 1976.
56.
CoatesD.The Labor Party and the Struggle for Socialism. Cambridge University Press, London, 1975.
57.
DomhoffG. W.The Higher Circles. Vintage Books, New York, 1971.
58.
HartTudor J.Industry and the health services. Lancet2: 611, September 15, 1973.
59.
BlackburnR.Ideology in Social Science. Random House, New York, 1973.
60.
TherbornG.Power in the kingdom of Sweden. International Socialist Journal2(7): 51–63, 1965.
61.
Democratic Junta and Convergencia Democratic programs in support of the democratization of Spain.Cambio, January 1976.
62.
AppelbaumA.New York City hospitals: The financial crunch. Hospitals50: 59, January 16, 1976.
63.
NavarroV.National health insurance and the strategy for change. Milbank Mem. Fund Q.51(2): 223–251, 1973.
64.
Revised list of NHI advisory panel members issued. Washington Information: National Health Insurance2–5, 1975.
Department of Health and Social Security.National Health Service Reorganization: England. Her Majesty's Stationery Office, London, 1972.
67.
GoughI.State expenditure in advanced capitalism. New Left Review92: 53–92, 1975.
68.
LeninV. I.The State and Revolution. International Publishers, New York, 1932.
69.
Trilateral Task Force.Governability of Democracies. Trilateral Commission, New York, 1975.
70.
WolfeA.New directions in the Marxist theory of politics. Politics and Society4(2): 131–159, 1974.
71.
U.S. Senate Committee on Government Operations.Confidence and Concern: Citizens View American Government. Government Printing Office, Washington, D.C., 1973.
72.
MillerA. H.Political issues and trust in government: 1964–1970. American Political Science Review68(3): 951–972, 1974.
73.
GramsciA.Prison Notebooks. International Publishers, New York, 1971.
74.
BravermanH.Labor and Monopoly Capital. Monthly Review Press, New York, 1975.
75.
McKeownT.An historical appraisal of the medical task. In Medical History and Medical Care, edited by McLachlanG., and McKeownT. M.. Oxford University Press, Oxford, 1971.
76.
EngelsF.The Condition of the Working Class in England. Stanford University Press, Stanford, 1958.
77.
NavarroV.The underdevelopment of health of working America: Causes, consequences and possible solutions. Am. J. Public Health6(6): 538–547, 1976.
78.
MillerA.The wages of neglect. Am. J. Public Health65(11): 1217–1220, 1975.
79.
CairnsJ.The cancer problem. Sci Am.233(18): 64–72, 1975.
80.
MatanoskiG.Lung Cancer by Census Tracts in the City of Baltimore. Unpublished Report, 1976.
81.
LalondeM.A New Perspective on the Health of Canadians. Government Printing Office, Canada, 1975.
82.
FuchsV.Health care and the U.S. economic system. Milbank Mem. Fund Q.50: 211–237, April 1972.
83.
OffeC.Political authority and class structure: An analysis of state capitalist societies. International Journal of Sociology2(1): 73–108, 1972.
84.
OffeC.The abolition of market control and the problem of legitimacy. Kapitalistate1: 109, May 1973.
85.
OffeC., and RongeV.Theses on the theory of the state. New German Critique6: 137, Fall 1975.
86.
BiermannS. S.ChristiansenV., and DohseK.Class domination and the political system. Kapitalistate2: 60, December 1973.
87.
RusconiG.Marxism in West Germany. Telos25, Fall 1975.
88.
MullerW., and NeusussC.The illusion of state socialism. Telos25, Fall 1975.
89.
BurnhamD.Ford termed cool to 3 key agencies. New York Times, January 16, 1976.
90.
Bevan and the doctors.Lancet2: 1196–1197, November 24, 1973.
91.
RobsonJ.The NHS Company Inc.?Int. J. Health Serv.3(3): 413–426, 1973.
92.
DraperP., and SmartT.Social science and health policy in the United Kingdom. Int. J. Health Serv.4(3): 453–470, 1974.
93.
ShearerD.The salt of public enterprise. Nation, February 21, 1976.
94.
Special Task Force to the Secretary of Health, Education, and Welfare.Work in America. M.I.T. Press, Cambridge, 1973.
95.
Organization for Economic Cooperation and Development.Expenditure Trends in OECD Countries, 1960–1980. OECD, Paris, 1972.
96.
MaxwellR.Health Care. The Growing Dilemma. McKinsey and Company, New York, 1975.
97.
SweezyP., and BaranP.Monopoly Capital. Monthly Review Press, New York, 1966.
98.
BowlesS., and GintisH.Schooling in Capitalist America. Basic Books, New York, 1976.
99.
YagoG.State Policy, Corporate Planning and Transportation Needs. University of Wisconsin, Madison, 1974 (unpublished).
100.
Doctors and the state.Wall Street Journal, January 16, 1976.
101.
ForsythG.Doctors and State Medicine. Pitman and Sons, London, 1973.
102.
WilenskyH. L.The Welfare State and Equality. University of California Press, Berkeley, 1975.
103.
The Cost of Social Security, 1964–65. International Labor Organization, Geneva, 1972.
104.
ProctorJ., and ProctorR.Capitalist development, class struggle and crisis in Italy, 1945–1975. Monthly Review27: 21–36, January 1976.
105.
MarxK.Critique of the Gotha Program. International Publishers, New York, 1938.
