Andrew C. Twaddle

Andrew C. Twaddle
Professor Emeritus

Ph.D., Brown University

Research and Teaching: 

Health Policy Changes in Sweden

This is a research project begun in 1990 as a result of my experience in a conference entitled Omvarlden serpa Svensk SjukvSrd [roughly Outsiders View Swedish Medical Care"] at which seven foreigners who had studied the Swedish medical care system were invited to share their findings and discuss implications for policy with 45 of the leading politicians, planners and medical care administrators in Sweden. It was evident at that conference that a sharp change had taken place in the direction of policy formation from solidarity and planning to markets, competition and privatization.

An analysis of documents from interest organizations and political entities, presented at the International Conference on Social Science and Medicine in 1992 was followed by a Fulbright Research Fellowship to Sweden in 1993. That enabled a more careful collection of documents and interviews with key decision makers in the health field (published Sweden as Restructuring Medical Care). The analysis of those data continues and a manuscript is under construction. Six chapters have been drafted, four will require major revision. One chapter remains to be drafted.

The line of argument is that the shot in policy cannot be explained by either structural problems in the medical care system or in the national economy. Instead, it marks a shim in the finance policy of the dominant Social Democratic Party based more on ideology than science.

Comparative Medical Care Reform

In a sense this is an extension of the Sweden project. At the 1994 meeting of the International Conference on Social Science and Medicine in Hungary, l managed to convene a group of scholars and health care policy people. We met in eight three-hour sessions to compare health reforms in a number of countries (some 35 participated at some point during the week, 22 were there most of the week). From those discussions, we developed a framework for making comparisons. It was agreed that I would coordinate an effort to enter into a collaborative project and we would meet again at the next Social Science and Medicine meeting in 1996 to continue our work. I have prepared a summary of the meeting for distribution to the participants and solicited their feedback. Based on that summary, I prepared a paper listing information that each participant would try to generate for his or her own country, again soliciting feedback. With refinements suggested by the others, I have set an agenda for the next meeting, which will take place in Scotland in 1996.

My current task is to prepare a "background paper" for the conference in which I will summarize our work to date and propose a set of theoretical considerations to guide our work. That paper will be one of the take-off points for discussion. It will be published in Social Science and Medicine prior to the meeting. Others at the conference will be invited to join us.



  • Death and Dying
  • Senior Seminar
  • Sociological Concepts and Health
  • Sociology of Health