6 - Australia: Politicized Professions and Tight Coupling of Health Care and Public Health

Summary

This case study analyzes the coevolution of the health care and the public health sec- tors in Australia. On the one hand, Australia is different from the UK, notably because it is a federal state, but on the other there are similarities between the two countries. Australia’s parliamentary system is similar to the UK, although there has been propor- tional voting for the Senate since 1948, which represents the territorial dimension. At the same time, Australia has a pluralist system of interest intermediation and is a lib- eral market economy; therefore, it should have politically active professions, such as the UK. Against this background, I expect the health care and public health sectors to be institutionally unified. In addition, there should be responsiveness between actors, such as discourse coalitions between the medical professions and public health organizations – especially once the context permits this. The historical analysis shows that there is distinctiveness and responsiveness (loose coupling) in the early time periods (especially t0). Nevertheless, both sectors coevolved towards tight coupling throughout the twentieth century. The results offer some support for my hypotheses stating that unified government leads to the unification of policy sectors and that politicized professions come along with responsiveness of health care and public health.