Shifting Sands

The author employs several theoretical approaches to explain these responses, including community/policy networks, institutionalism, and state traditions, and uses case studies to illustrate the intense interest group activity that has occurred in this sector. Boase reaches three conclusions: (1) with the development of a national health insurance plan, government actions have shifted from reliance on interest group liberalism towards concerted efforts to plan the structure of the welfare system; (2) the different systems of interest intermediation that evolved in the provinces reflect the underlying political and administrative culture and institutional structures within the provinces; and (3) the unique proactive approach taken by Ontario in the 1980s was a deliberate effort to modify the institutional arrangements through which groups had traditionally influenced policy. Boase suggests that the complexities of modern government and the move towards redistributive politics will lead the positive state to make extraordinary efforts to control its environment in the future.

Shifting Sands will be of particular interest to health care specialists and activists as well as policy-makers and legislators.