Big bang and the policy prescription: Health care meets the market in New Zealand

This article discusses events that led up to and the aftermath of New Zeala nd's radical health sector restructuring of 1993. It suggests that "big ban g" policy change facilitated the introduction of a set of market-oriented i deas describable as a policy prescription. In general, the new system perfo rmed poorly, in keeping with problems of market failure endemic in health c are. The system was subsequently restructured, and elements of the 1993 str uctures were repackaged through a series of incremental changes. Based on t he New Zealand experience, big bang produces change but not necessarily a p redictive model, and the policy prescription has been oversold.