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Social Movements and the Transformation of American Health Care$
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Jane Banaszak-Holl, Sandra Levitsky, and Mayer Zald

Print publication date: 2010

Print ISBN-13: 9780195388299

Published to Oxford Scholarship Online: September 2010

DOI: 10.1093/acprof:oso/9780195388299.001.0001

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Social Movement Challenges to Structural Archetypes

Social Movement Challenges to Structural Archetypes

Abortion Rights, AIDS, and Long-Term Care

(p.128) 9 Social Movement Challenges to Structural Archetypes
Social Movements and the Transformation of American Health Care

Martin Kitchener

Oxford University Press

This chapter extends institutional theory to analyze processes by which resource‐poor actors initiate new structures within fields of healthcare organizations. Using insights from studies of counter‐movements, political opportunity structures, and social processes, a series of propositions are derived and illustrated using three case studies of institutional change driven by health reform movements: abortion rights, AIDS, and long‐term care. The framework assumes that multiple belief systems (logics) within healthcare fields ensure that institutional arrangements will be challenged, sometimes by reform movements. Five aspects of political opportunity structures support such efforts: organizational fields that are centralized and immature, an open policy context, a decentralized state, neighboring fields of reform activity, and journalistic standards of balanced reporting. Health reform movements are enabled by networked forms of leadership, the development of equivalent capacities to counter‐movements, and leaders framing an array of arguments. Successful reform processes are likely to be slow, highly contested, and result in the new structure being accommodated alongside aspects of the traditional arrangements.

Keywords:   belief system, institutional theory, health social movements, counter‐movements, political opportunity structures, archetypes

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