Varying Costs to Change? Institutional Change in the Public Sector

Many scholars have argued that social programs are marked by a logic of “increasing returns” that makes change difficult. Yet over the past decades, reformers across industrialized countries have introduced substantial administrative reforms in these services, even as entitlement reform remains politically difficult. This paper explains these shifts by breaking apart the logic of “increasing returns” into three distinct “costs to change”: technical, political, and expectations. Decreases in a particular type of costs produce different logics of institutional change—back end, informal, and front end—that privilege the state, professionals or private, or political actors in distinct ways. I support these claims by reexamining three cases that were considered exemplars of stability but that ultimately had major entitlement reform: health care in the U nited K ingdom and U nited S tates and welfare programs in the U nited S tates. I show that even before radical reforms occurred, reformers introduced distinct logics of administrative change that underpinned later changes.