American Health Care: Paradigm Structures and the Parameters of Change

Despite general agreement that US health care is in crisis, little change has occurred; how this is to be explained is examined. The paradigm concept can be applied to US health care; it suggests that changes will occur only when the intractibility of problems apparent to health care practitioners becomes unmanageably great. Review of current literature suggests that the system is entering a state of crisis. Resolution of this crisis will necessarily be a political process. W. H. Stoddard.