Part II revisits episodes in the foundational period of the welfare state in each nation: but views them in the light of the new framework I am presenting, as well as providing important background for the later discussion of the contemporary cases. In the case of the founding of the National Health Service in post-war Britain in a “big-bang” strategy (Chapter 3), my argument accords with established understandings of the episode, and the case serves to provide a sort of benchmark or quintessential example of big-bang change. In other cases, such as the almost simultaneous establishment of US and Canadian versions of “medicare” in the mid-1960s (Chapters 3 and 4 respectively), my conceptual framework offers a new perspective. In the case of Canadian medicare, the analysis shows the importance of a framework that illuminates the assumptive worlds of strategic decision-makers, to explain the pursuit of a big-bang strategy even in conditions (a minority federal government, an intergovernmental division of powers) that would seem inimical to such an approach. The establishment of US Medicare and Medicaid through a “mosaic” strategy can be seen to have demonstrated the constraints of the American system that have shaped the assumptions of political actors to such an extent that the political leadership enjoys extraordinary institutional and electoral resources and has a strong political will to act, the strategy of choice is still likely to be a set of relatively small-scale, fast-paced changes. We will see a similar example in the Obama reforms of 2010 (Chapter 6).

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