The economic disorders of the last decade have compelled European welfare states to seek more stringent controls over costly social policies such as health care, thus circumscribing professional sovereignty. However, several factorsinstitutional structure, cultural values, political/economic circumstances, patterns of state/professional relationsconstrain the policy alternatives available to governments, and make fundamental reform very difficult to achieve. After analyzing these factors and the reform policies adopted in France, Great Britain, and West Germany, this article will examine and compare the strategies pursued to meet professional resistance to change.

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