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Institutionalized Healthcare Reform in Germany? Error Correction or Political Strategy?

Author: SYLVIA PANNOWITSCH
Published in GPS, Vol. 5 No. 1

During recent years, German Health Policy has been subject to extensive reform activity. Since the early 1990s, there have been at least seven substantial healthcare reforms and many smaller ones. Against this background, the paper argues that it is more apposite to speak of one ―institutionalized reform‖, instead of separate reforms. Every single reform seems to be only one step, which in itself does not end the reform process, but which is another step in the direction of the next reform. On the basis of three case studies, the paper argues that there is a basis of one ―institutionalized reform‖ (but to be implemented in small steps) in the reform process for two main reasons: either the reform has been planned badly or planned as a learning system and has to be adjusted to correct deficiencies as they ap-pear, or the new reform is the result of the disability of the actors to achieve the reform they want and a ‗step by step‘ strategy is being used to reach the aims after a second or third attempt.

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