A shift in the historical trajectory of medical dominance: The case of Medibank and the Australian doctors' lobby

Jennifer Devoe, Stephanie D. Short

Research output: Contribution to journalArticle

15 Citations (Scopus)

Abstract

During the twentieth century, episodes of major health policy reform were relatively rare. These rare episodes were pivotal 'critical junctures' in determining the paths taken by modern health systems and in creating a unique health policy arena. A pivotal 'turning point' in Australia came in the form of national health insurance. Introduced in the early 1970s, Medibank (universal, compulsory national health insurance) was the first significant structural health policy change in Australia during the twentieth century. When Medibank health insurance proposals were presented in Australia, political struggles erupted. Government leaders in Australia faced fierce opposition from key players within the health policy arena. Prior to this turning point, one of the key health policy players - the Australian Medical Association (AMA) - had developed a corporate partnership with the non-Labor government. When the Medibank proposal emerged, power structures in the health policy arena were re-aligned. The political role of the AMA shifted from a corporate partner to a pressure group. Examining the political processes surrounding this unique episode of major health policy change helps to illuminate the dual and dynamic nature of the doctors' lobby. Our study aims to demonstrate empirically Day and Klein's proposition that the doctors' lobby operates as a pressure group, rather than as a corporate-style partner, during periods of structural reform in health care [Political Studies, 40 (1992) 462]. This case study of the doctors' lobby during Medibank negotiations represents a rare break in the tradition of ultimate medical professional veto power in health policy decision-making and provides empirical evidence that challenges a widely held perception about an inevitable historical path of medical dominance.

Original languageEnglish (US)
Pages (from-to)343-353
Number of pages11
JournalSocial Science and Medicine
Volume57
Issue number2
DOIs
StatePublished - Jul 2003

Fingerprint

health policy
lobby
Health Policy
trajectory
health insurance
pressure group
medical association
National Health Programs
twentieth century
Pressure
structural reform
Health Care Reform
political process
Lobbies
Medical dominance
Doctors
Trajectory
Health policy
policy reform
Policy Making

Keywords

  • Critical junctures
  • Health insurance
  • Path dependence
  • Pressure group politics
  • Professional dominance
  • Punctuated equilibrium

ASJC Scopus subject areas

  • Economics and Econometrics
  • Public Health, Environmental and Occupational Health
  • Social Psychology
  • Development
  • Health(social science)

Cite this

A shift in the historical trajectory of medical dominance : The case of Medibank and the Australian doctors' lobby. / Devoe, Jennifer; Short, Stephanie D.

In: Social Science and Medicine, Vol. 57, No. 2, 07.2003, p. 343-353.

Research output: Contribution to journalArticle

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