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Healthy or Sick?
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Book description

The book analyses how policies to prevent diseases are related to policies aiming to cure illnesses. It does this by conducting a comparative historical analysis of Australia, Germany, Switzerland, the UK, and the US. It also demonstrates how the politicization of the medical profession contributes to the success of preventative health policy. The book argues that two factors lead to a close relationship of curative and preventative elements in health policies and institutions: a strong national government that possesses a wide range of control over subnational levels of government, and whether professional organizations (especially the medical profession) perceive preventative and non-medical health policy as important and campaign for it politically. The book provides a historical and comparative narrative to substantiate this claim empirically.

Reviews

'Trein’s book is a remarkable achievement, stimulating, deeply informed and addressing some of the most vexing issues in the application of institutional/historical frameworks to complex policy developments. From an interest in how policy sectors coordinate well or poorly, Trein treats five country cases as evidence for his view that overall governance arrangements shape whether, in the policy fields of public health and medical care are integrated and cooperative or not. The theory, the applications, and findings make a genuine contribution of the comparative and historical study of health policies, a field much in need of theoretical clarity and accurate cross-national evidence.'

Theodore Marmor - Yale University, Connecticut and co-author of Politics, Health, and Health Care

'Most studies of health policy focus on the care provided by doctors and hospitals, mostly to patients who are already ill. This excellent book links that type of health policy with preventative health policy in the form of public health. Philipp Trein’s book is a very important addition to policy studies, and especially policy studies demonstrating the importance of this linkage, and the ways in which those two complementary dimensions have been linked more or less successfully in a number of countries.'

B. Guy Peters - Maurice Falk Professor of Government, University of Pittsburgh

'To what extent are health care and public health policy sectors integrated or distinct in modern democratic states? An answer to this question is critical to address the global sanitary challenges of the twenty-first century such as aging, massive global migrations, the emergence of new communicable diseases, and many others that require rapid and coordinated responses from both systems. Anchored in a strong conceptual framework based on institutional and professionalization theory, Trein’s detailed analysis of the co-evolution of the two sectors in 5 countries, provides a compelling argument for their complementarity.'

Louise Potvin - Université de Montréal

'Cross-sectoral coordination is a salient issue across healthcare systems and is high on current health policy agendas in many countries. Philipp Trein’s study of the coevolution of healthcare and public health makes a timely contribution to current health policy debates as well as to the emerging field of the politics of public health. The cross-country comparative approach allows identifying specific institutional conditions for integration, while the historical country case studies provide valuable insights into how the specific mechanisms have evolved. Combined, the study highlights the contingency of cross-sectoral coordination and cautions against any quick-fix solutions.'

Viola Burau - Aarhus University, Denmark

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