that countries are involved in ongoing, dynam- ic class struggles in the development of health- systems. His neo-Marxist framework, influenced by Wallerstein’s world-systems theory, allows for countries to move back and forth among five types: core capitalist (e.g., the United States and Germany), core capitalist/social welfare (e.g., Cana- da, Japan, Sweden, United Kingdom), industrial- ized socialist-oriented (e.g., pre-1990s Soviet and COMPARATIVE HEALTH-CARE SYSTEMS 377 eastern European systems), capitalist dependen- cies in the periphery and semi-periphery (e.g., Brazil and India), and socialist-oriented, quasi- independent of the world system (e.g., China and Cuba). In 1990, Esping-Andersen (1990) contributed an important theoretical framework to the field of comparative welfare states research, that can also be useful in distinguishing among health-care sys- tems in advanced capitalist nations. Esping-Ander- sen conceptualizes all welfare activities, including health-care, as a product of a state-market-family nexus. His typology organizes ‘‘welfare regimes’’ around this nexus, specifically as it results in the decommodification of workers in a country; that is, the degree to which a citizen can obtain basic health and social welfare services outside of the market. In terms of health-care, this would mean a citizen’s ability to access health-care services without having to purchase them ‘‘out-of-pock- et.’’ Esping-Andersen identifies three types of sys- tems: conservative or corporatist, liberal, and socialist or social democratic. In The Three Worlds of Welfare Capitalism, he constructs measures of decommodification that he applies to data from eighteen nations in order to assess where each nation’s welfare regime ranks according to the three types. Under Esping-Andersen’s scheme, so- cial democratic systems include the Nordic coun- tries and the Netherlands; liberal systems include Canada, Japan, and the United States; and the conservative or corporatist welfare states include France, Germany, and Italy. These placements appear similar to what Graig proposed using a much simpler public-private dimension; however, Esping-Andersen’s methodology is unique in its theoretical approach and because it can be operationalized quantitatively to allow precise dis- tinctions among a large number of nations. Reviewing various health-care system frame- works shows a wide variety of approaches and scholarly emphases. Comparative research is in the process of moving beyond simple typologies to focus on the conditions under which different types of systems emerge and under which they change. This work demonstrates the value of a broad approach, integrating the key aspects that affect the development of health-care systems, including historical, cultural, political, and eco- nomic factors. REVIEW OF SELECTED HEALTH-CARE SYSTEMS Comparative international research on health-care systems requires information that is both detailed and current. Obtaining data is complicated by the fact that health-systems throughout the world op- erate in a state of constant flux. These summaries present the most recent information available for the health-care systems of selected countries. Among countries with advanced economies, Swe- den and the United States often occupy opposite extremes when it comes to health-care organiza- tion and financing. For this reason, Sweden is the first country discussed along with three countries that have similar systems—Finland, the United Kingdom, and Canada—followed next by Germa- ny, Japan, Russia, and China, with additional dis- cussions of France, Mexico, Argentina, Chile, Co- lombia, and Ghana. Swedish health-care reflects three basic princi- ples: equality among citizens in access to health- care; universality in the nature of services (the idea that everyone should receive the same quality of services); and solidarity, the concept of one social group sacrificing for another group in the interest of the whole society (Zimmerman and Halpert 1997). Solidarity in this context refers to taxing those who use fewer services at the same rate as those who use more—for example, similar health- care taxation for younger persons or affluent per- sons versus the elderly or the poor). The Swedish health-care system is predominantly a publicly owned and funded system; thus, approximately 85 percent of Swedish health-care is publicly funded, whereas in the United States the public portion is just under 50 percent (Lassey, Lassey, and Jinks 1997). The differences between the two systems are more startling in terms of the growth of overall spending. In the early 1980s, both countries were spending approximately 9.5 percent of their Gross Domestic Product on health-care. By the end of the century, the situation had changed dramatical- ly; in 1999, Sweden was spending 8.6 percent ($1728 per capita) compared to 13.5 percent ($3924 per capita) in the United States (Anderson and Poullier 1999). Populations in the two nations also differ markedly on several basic health status indi- cators. Infant mortality Sweden is four deaths per thousand live births compared to 7.8 in the United States. Swedish men live nearly four years longer COMPARATIVE HEALTH-CARE SYSTEMS 378 on average than American men, and Swedish wom- en live two years longer than their American coun- terparts. These favorable statistical indicators com- pel a closer look into how the Swedish health-care system is organized. The Swedish welfare state, including health- care and social services, is one of the most compre- hensive and universal in the world. Health-care in Sweden is the responsibility of the state, which delegates it, in turn, to each of Sweden’s twenty- one county councils (Swedish Institute 1999). Elect- ed officials in each county are charged with provid- ing comprehensive health services for residents, and with levying the taxes to finance them. The system is decentralized; each county by law must provide the same generous common core of serv- ices to all residents, although just how they decide to do it can vary. In the 1990s, Sweden embarked on a series of reforms in order to increase health- care quality and efficiency. As a result, Swedish citizens now have greater freedom in choosing their own primary care physicians. The vast ma- jority of these doctors are employed by the county councils to practice in small group clinics and health centers distributed geographically through- out the country. Specialist physicians practice in hospitals where they also see outpatients on both a referral and self-referral basis. The medical divi- sion of labor also includes district nurses, physical therapists, and midwives, all of whom are used extensively to deliver care through local health centers (maternity clinics in the case of midwives). Midwives also work in hospitals where they have responsibility for normal cases of labor and deliv- ery. Sweden’s elderly constitute an increasing pro- portion of the population, creating significant chal- lenges for both current and future health and social services. Sweden’s social policy emphasizes that citizens should be able to live in their own homes for as long as possible, meaning that nurs- ing home placement occurs only when absolutely necessary. Services for the elderly may involve as many as five or six home nursing visits per day in order for the disabled and elderly to remain at home in the community. Swedish citizens are taxed heavily to maintain the quality and level of services they expect; at the same time, they have shown high levels of political support for maintaining their expensive system. In the 1980s, many services were entirely free; howev- er, today there typically is a modest copayment. The copayment for a primary care physician visit, for example, currently ranges from $12 to $17 depending on the county council. For specialist physician visits the copayment ranges from $15 to $31, and for hospital stays it is fixed at $10/day. The Swedish system includes a high-cost ceiling so that, after a person spends approximately $113 out-of-pocket each year, health-care services are free. Medications must be purchased by the indi- vidual until they have reached a threshold of a little more than $100. Prescriptions are then discount- ed until the patient has spent $225, at which point medications become free (Swedish Institute 1999). These amounts have increased somewhat during the 1990s, but due to Swedens already high taxa- tion rate, county councils were hesitant to ask patients to pay more. Reforms during the same period included establishing internal performance incentives or ‘‘public competition’’ (Saltman and Von Otter 1992), a structural arrangement that arguably enabled Sweden to maintain the basic features of its health-care system without large tax or out-of-pocket increases. Some have expressed concern that the system is stretched to its limits. Regardless of which view is correct, the Swedish system requires a healthy economy in order to continue, given continuing cost pressures and an increasingly aged population. The Swedish model of a publicly owned and financed health-care system shares common fea- tures with systems in several other countries, in- cluding the United Kingdom, Finland, and Cana- da. The British National Health Service (NHS), like its Swedish counterpart, provides publicly fund- ed, comprehensive health-care to the population, and enjoys a solid base of citizen support, albeit under ongoing criticism. What distinguishes the NHS from health-care systems in other Western countries is its frugality. Characterized by long waiting lists and what Klein (1998) refers to as ‘‘rationing by professionally defined need,’’ Brit- ain runs the cheapest health-care system in Eu- rope, outside of Spain and Portugal. In the early 1990s, the NHS went through a series of dramatic changes, creating ‘‘internal markets,’’ a system of inside competition intended to increase produc- tivity and further decentralize its historically large and unwieldy bureaucracy. These reforms—sever- al of which were adopted by Sweden—reorgan- ized primary care practices and shifted physician payment from fixed salary to capitation. NHS COMPARATIVE HEALTH-CARE SYSTEMS 379 hospitals also entered into new arrangements where they have greater structural independence and compete among themselves. In 1997, the British government introduced new proposals that changed course yet again. The direction of the NHS in the twenty-first century is unclear (Klein 1998). Finland’s health-care system also is publicly owned, financed through general taxation, and decentralized. In fact, Finland operates with more health-care decentralization than Sweden. Since 1993, Finnish funding for health-care has been incorporated into block grants from the national government that are given annually to each of the country’s 455 municipalities, some of which form partnerships for purposes of delivering health- care (Hermanson, Aro, and Bennett 1994). Within the parameters of national guidelines, elected offi- cials in each of these jurisdictions (similar to the county councils in Sweden) have the responsibility to obtain and deliver health-care services to the population. High standards, a comprehensive ar- ray of services, as well as modest out-of-pocket payments, make the Finnish system comparable to the Swedish system. Canada also provides health- care to its entire population. The Canadian system is administered by the provinces and is financed largely by public taxation, roughly three-quarters of which is from the provincial government. While basic services remain constant, some specific pro- visions of health-care in Canada vary considerably from province to province. Unlike in Sweden, Finland, and the United Kingdom, Canadian phy- sicians are paid on a fee-for-service basis. Further- more, Canadian primary care physicians act as gatekeepers to specialists and hospitals (much as they do in Finland and the United Kingdom, but not in Sweden). As is the case with all the countries in this group of four, Canadians have extreme pride in their health-care system. They appear resolute in maintaining it, although a number of controversial cost-cutting measures and as yet un- solved problems raise considerable concern about the future (Lassey, Lassey, and Jinks 1997). Germany and Japan, as well as France, have achieved comprehensive and universal coverage (92 percent in the case of Germany) with a model that is closer to that of the United States than the social democratic model of Sweden discussed above (U.S. General Accounting Office 1991). In all three of these countries, medical care is provided by private physicians, by both private and public hos- pitals, and patients can choose their physicians. Benefits are comprehensive and mandated by the national government, which also regulates enroll- ment, premiums, and reimbursement of providers. In contrast to the four countries discussed earlier, financing in Germany, Japan, and France is pre- dominantly private with multiple payers. Workplace- based insurance (financed typically through pay- roll deductions) covers most employees and their dependents while other payers cover the remain- der of the population. Patients make copayments for physician visits and hospital stays, ranging from a nominal amount in Germany to as much as 20 percent or 30 percent of the fee in France and Japan. There is national regulation to ensure con- sistency. Coverage and care conditions vary from fund to fund, resulting in greater inequalities of benefits compared to the public systems of Swe- den, Finland, Canada, and the United Kingdom. Arguing that such systems actually help maintain social divisions and inequality, Esping-Andersen (1990) refers to them as conservative or corporatist. Although Germany privately finances much of its health-care system, the national government plays a strong role. All but the most wealthy of German citizens are required by law to join one of Germany’s 750 insuring organizations, called ‘‘sick- ness funds.’’ In practice, all but about 10 percent of the population opt to join the system, encour- aged to participate by the great difficulty of getting back in later on. Sickness funds are private, non- profit organizations that collect premiums or ‘‘con- tributions’’ for each member—half paid by the individual and half by the employer—and, in turn, contract for health services with physician organi- zations and hospitals. One of the biggest problems for the German system is continuing cost pres- sures, exacerbated by the reunification of East and West Germany in 1991. The system uses fixed budgets for hospitals and strict fee schedules for physicians, with punitive measures for inordinate increases in volume, to combat the problem. These were tightened in a major 1993 reform that im- posed strict three-year budgets on all major sectors of the system as well as longer-term structural reforms. Early results have been positive (U.S. General Accounting Office 1994). Japanese health-care follows much the same private, multi-payer model as in Germany, with health-care provided to all citizens through 5,000 COMPARATIVE HEALTH-CARE SYSTEMS 380 independent insurance plans. The plans fall into three major groups, each enrolling about a third of the population: large-firm employees, small- firm employees, and self-employed persons and pensioners. In the case of the first two plans, as is the case with the German sickness funds, the employer pays approximately half of the premium and the employee pays the remaining portion. The similarity to the German system is no accident; Japan has consciously patterned its health-care syatem after Germany’s, dating back to its mod- ernization in the late nineteenth and early twenti- eth centuries (Lassey, Lassey, and Jinks 1997). Despite these similarities, Japan’s health-care sys- tem presents some unique and somewhat startling features compared to the other systems dis- cussed here. Compared to other systems with a significant private component, the Japanese system costs con- siderably less (Andersen and Poullier 1999). In 1997, for example, per capita health-care spending in Japan was $1741, less than in the United States, Canada, France, Germany, and many other Euro- pean countries. Of the nations discussed here, only the austere British system ($1347 per capita) and efficiency-conscious Finnish system ($1492 per capita) spent less. Japan’s economical approach to delivering health-care raises two paradoxes. First, the low levels of spending would seem to contradict the fact that Japan currently has the longest life expectancy and the lowest infant mor- tality in the world. In addition, utilization rates in Japan are high, which some would argue indicates a sicker rather than a healthier population. Specifi- cally, the Japanese visit physicians two to three times more frequently, stay in the hospital three to four times longer, and devote considerably more health spending to pharmaceuticals than the other nations discussed here. How can these contradic- tions be explained? Ikegami and Campbell (1999) argue that, in part, the paradox can be explained by the country’s much lower incidence of social problems related to health, such as crime, drug use, high-speed motor vehicle accidents, teen-age births, and HIV infections. Less aggressive medi- cine and lower hospital staffing and amenities also are thought to keep down costs in Japan. Health-care arrangements in nations where the political economy is neither ‘‘advanced’’ nor a stronghold of capitalistic democracy can also be instructive. During the latter part of the twentieth century and until today, both China and Russia have been faced with the monumental challenge of providing health-care with very limited financial resources to huge, diverse populations, many of which live under poor social conditions. Their health-care systems, however, are quite different and their current problems reflect the distinctive political and economic trajectories of the two coun- tries. Russian health-care at the dawn of the twen- ty-first century is a system in crisis. Based on socialist principles of universal and free access, the old Soviet system included a primary care network of local clinics (‘‘polyclinics’’) typically connected to a general hospital, as well as more specialized hospitals. This means that a regional city might have separate hospitals for emergencies, materni- ty, children, and various infectious diseases (Albrecht and Salmon 1992). Funding came directly from the central government until 1993 when a new health insurance law was approved, shifting the source of financing to employer payroll deduc- tions. There are major questions, however, as to whether such a system can be effective during the current period of resource scarcity and instability in major social institutions (Lassey, Lassey, and Jinks 1997). Chinese health-care, for most Westerners, evokes images of acupuncture and other forms of Eastern medicine, as well as the idealized ‘‘bare- foot doctors’’ of the 1960s and 1970s, practition- ers with basic medical training who provided pri- mary care in rural areas. In reality, traditional Chinese medicine exists alongside an increasingly dominant Western medical establishment, and the barefoot doctors have all but disappeared. Since new leadership took over the Communist Party in the late 1970s, China has encouraged privatization and decentralization in health-care. By the 1990s, nearly half of all village health-care was provided by private practitioners (Lassey, Lassey, and Jinks 1997). These changes reportedly have been ac- companied by a decline in preventive care and public health efforts in rural areas. At the same time, the situation in urban areas seems to have improved. China’s revolutionary-era network of local and regional clinics and hospitals has been modernized, although resource shortages contin- ue to limit the level of technological advancement. The most significant change in China is the grow- ing impact of privatization, which appears to be bringing China many of the same problems that COMPARATIVE HEALTH-CARE SYSTEMS 381 have plagued privatized systems elsewhere: lack of insurance coverage, increasing costs, maldistribution of providers, and inequalities in the overall quality of care (Liu, Liu, and Meng 1994). As in the United States, the gap between the health-care received by the rich and that received by the poor is growing (Shi 1993). Huge disparities between the rich and poor are characteristic of Latin America where they constitute a significant barrier to universal health coverage. Latin-American health-systems vary con- siderably, reflecting socioeconomic differences be- tween countries as well as historical and political contingencies. The Mexican system illustrates many of the obstacles faced by developing nations, wheth- er in Latin America or elsewhere. The Mexican constitution established federal responsibility for health-care in 1917, along with a centralized ad- ministrative tradition that still exists; yet, to date, the two major government insurance schemes cov- er only about 47 percent of the population, with another 7 percent insured privately. Ostensibly, there are programs for the remaining 46 percent of the population, most of whom are low income, but in reality, many low income areas and impov- erished communities are poorly served. Some have argued that a basic health-care infrastructure is in place and that there are sufficient numbers of well- trained health-care professionals available (Lassey, Lassey, and Jinks 1997). They contend that, had it not been for several national crises in the 1980s and 1990s, coupled with a lack of political will, more of the Mexican population would now be covered by the health-care system. Bertranou (1999) has compared Argentina, Chile, and Columbia, all of which have employed various ways to reform health insurance arrange- ments in recent years. Chile’s reforms date back to its military dictatorship in the early 1980s. At that time, private health insurers were allowed to com- pete for worker payroll contributions. There was little regulation of the system which encouraged adverse selection, resulting in significant inequi- ties within the system. Even so, approximately 70 percent of the Chilean population today is covered by insurance, compared to 64 percent in Argenti- na and only 43 percent in Colombia. Argentina faces numerous obstacles in reforming its com- plex and confusing system of three types of health- care arrangements (social insurance organizations, private health insurers and providers, and the public health-system). Its goals include universal coverage and a standard benefits package. In the case of Columbia, reform goals are more related to the relative poverty in the country and the fact that large segments of the population cannot af- ford health insurance. Per capita expenditures for health-care in Columbia are 42 percent of what they are in Chile and 20 percent of the expendi- ture level in Argentina. Instead of giving free access to public facilities, Columbia’s reforms in- volve providing vouchers that allow low-income families to join the health organization of their choice. To be successful, all these reform efforts require social equilibrium where governments are able to maintain political and economic stability. The political instability and socioeconomic inequality that have characterized Latin America are also a hindrance to health-care systems in Africa. An even more fundamental problem in Africa, however, is the formidable lack of resourc- es to address overwhelming health-care needs (Schieber and Maeda 1999). Even where clinics, hospitals, and medical personnel exist, there is likely to be a lack of the required equipment and medicines. In Africa as a whole, 80 percent of the physicians live and practice in the cities where less than 20 percent of the population lives. According to Sanneh (1999), this continuing situation sup- ports the prominent role of traditional healers, 85 percent of whom live in rural areas. The difficul- ties encountered by Ghana in implementing a system of primary care illustrate the situation af- fecting many African nations. In 1983, soon after the primary care system was adopted, the govern- ment attempted cost containment by introducing ‘‘user fees’’ in all public health facilities, clinics as well as hospitals. Two years later the fees were increased and, subsequently, a health insurance program was instituted. One must question the practical significance of these developments in a country where over half of rural residents and nearly half of those in urban areas live below poverty (Anyinam 1989). These circumstances are a reminder that developing countries contain 84 percent of the world’s population, yet account for only 11 percent of global health-care spending (Schieber and Maeda 1999), making the task of designing strategies for effective health-care deliv- ery in the developing world the true challenge for comparative health-care system researchers. COMPARATIVE HEALTH-CARE SYSTEMS 382 Comparing health-care systems entails a vast array of information, including historical back- ground, cultural patterns and beliefs, geographic considerations, as well as social, economic, and political factors. It involves detailed descriptions of policies and procedures, complex statistical profiles, as well as an understanding of conceptual frameworks, theory, and comparative methods. The potential rewards of comparative work, how- ever, balance the challenges. Whether there is convergence in the structure and functioning of health-care systems or not, many of the problems faced by nations in delivering health-care to citi- zens are similar. There are lessons to be learned from comparing health-care systems internation- ally that can only aid in addressing these problems. REFERENCES Albrecht, Gary L., and J. Warren Salmon 1992 ‘‘Soviet Health-care in the Glastnost Era.’’ In Marilyn Rosenthal and Marcel Frenkel, eds., Health-care Systems and their Patients: An International Perspective. Boulder, Co: Westview Press. Anderson, Gerard F., and Jean-Pierre Poullier 1999 ‘‘Health Spending, Access, and Outcomes: Trends in Industrialized Countries.’’ Health Affairs 18:178–192. Anderson, Odin W. 1989 The Health Service Continuum in Democratic States: An Inquiry into Solvable Problems. Ann Arbor, Mich.: Health Administration Press. Anyinam, C. 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MARY KO ZIMMERMAN COMPARATIVE-HISTORICAL SOCIOLOGY Explicit analytic attention to time and space as the context, cause, or outcome of fundamental social processes distinguishes comparative-historical analy- sis from other forms of social research. Historical processes occurring in or across geographic, po- litical, or economic units (e.g., regions, nation- states, multi-state alliances, or entire world sys- tems) are systematically compared for the purpos- es of more generally understanding patterns of social stability and social change (Abrams 1982; Skocpol 1984a; Tilly 1984; Mahoney 1999). Three very different and influential studies illustrate both the kinds of questions comparative-historical sociolgists address and the approaches they use. First is the classic study by Reinhard Bendix ([1956] 1974) on work and authority in industry. Bendix initially observed that all industrial socie- ties must authoritatively coordinate productive activities. Yet by systematically comparing how this was done in four countries during particular historical periods—pre-1917 Russia, post-World War II East Germany, and England and United States during epochs of intense industrialization— he showed that national variation in ideologies of workplace dominance were related to differences in the social structures of the countries studied. Second is the analysis of the historical origins and development of the modern world system by Immanuel Wallerstein (1974). Wallerstein took as his unit of analysis the entire sixteenth-century capitalist world economy. Through comparing in- stances of the geographic division of labor, and especially the increasing bifurcation of global eco- nomic activity into ‘‘core’’ and ‘‘peripheral’’ areas, Wallerstein suggested that the economic interde- pendence of nation-states likely conditions their developmental trajectories. Third is the analysis of social revolutions by Theda Skocpol (1979). Skocpol compared the his- tories of revolution in three ancient regime states: pre-1789 France, czarist Russia, and imperial Chi- na, and found that revolutionary situations emerged in these states because international crises exacer- bated problems induced by their agrarian class structures and political institutions. She then but- tressed her causal generalizations by comparing similar agrarian societies—Meiji Japan, Germany in 1806 and 1848, and seventeenth century Eng- land—that witnessed failed revolutions. Each of these influential studies combined theoretical concepts and nonexperimental research methods to compare and contrast historical proc- esses occurring within and across a number of geographic cases or instances. By using such re- search methods, Bendix, Wallerstein, Skocpol, and many others are following in the footsteps of the founders of sociology. In their attempts to under- stand and explain the sweeping transformations of nineteenth-century Europe, Alexis de Tocqueville, Karl Marx, Emile Durkheim, and Max Weber all employed and contributed to the formulation of this broad analytic frame (Smelser 1976; Abrams COMPARATIVE-HISTORICAL SOCIOLOGY 384 1982). Comparative-historical analysis in sociolo- gy—and, as we shall see, debate over how it should be conducted—thus is as old as sociology itself. PURPOSES, PROMISE, ACHIEVEMENTS The analytic power of comparative-historical strate- gies stems from the uniquely paradoxical quality of the perspectives, data, and procedures in com- parative-historical research. On the one hand, his- torical comparisons have the potential to harness and exploit the huge variation in social processes and institutions. Some scholars believe this essen- tial to the development of truly general theory and to transcultural/transhistorical explanation (Przeworski and Tuene 1970; Kiser and Hechter 1991). On the other hand, historical comparisons have the potential to exploit the ‘‘time-space boundedness’’ of social life and its historical ante- cedents and specificity. Others view this as equally essential to theoretical development and to con- crete, ‘‘real world’’ explanation (Moore 1966; Skocpol 1984b; Tilly 1984; Stryker 1996). Most comparative-historical sociologists capitalize in some fashion on this paradox, finding diversity in the midst of uniformity and producing regularities from differences. One of the great advantages of historical com- parisons is that they reduce bias induced by cultur- ally and historically limited analyses and interpre- tations of the social world. Social structures and processes in the past were generally quite different from those observed today, and contemporary institutional arrangements and social relations dif- fer substantially across cultures, regions, and states. Patterns of historical change and continuity, moreo- ver, have varied from one country or culture to another. Some scholars, such as Bendix (1963, [1956] 1974), relish this diversity and use historical comparisons to emphasize and interpret the pecu- liarities of each case. Even seeming uniformities across cases may mask important differences, and comparative-historical inquiry may be used to de- tect these ‘‘false similarities’’ (Bloch [1928] 1969). Examination of historical or national differ- ences also can lead to the detection of previously unknown facts that may suggest a research prob- lem or pose a hypothesis amenable to empirical exploration. Marc Bloch ([1928] 1969), for exam- ple, tells of how his knowledge of the English land enclosures led him to discover similar events in France. Comparing histories also aids in the for- mation of concepts and the construction of ‘‘ideal types’’ (Weber 1949; Bendix 1963; Smelser 1976). For example, Weber’s ([1904] 1958) concepts of ‘‘the Protestant ethic’’ and ‘‘the spirit of capital- ism’’ and Wallerstein’s (1974) notion of the ‘‘world system’’ derive from comparative-historical inquiry. Linking apparently disparate historical and geo- graphical phenomena, as Karl Polanyi ([1944] 1957) does when he relates the gold standard to the relative geopolitical tranquility throughout much of the nineteenth century, also is one of the fruits of comparative-historical analysis. New informa- tion, conceptual development and the discovery of unlikely commonalties, linkages, and previously unappreciated differences are necessary for the generation, elaboration, and historical grounding of social theory. The analysis of comparative-historical patterns can allow for more adequate testing of established theory than does study of a single nation, culture, or time period. Plausible theories of large-scale social change, for example, are intrinsically processual and so require historical analysis for a genuine elaboration or examination of their hypotheses (Tilly 1984). Historical comparisons also can be used to assess the generality of putative ‘‘univer- sal’’ explanations for social structure and social action (e.g., functionalism, Marxism). Abstract propositions thought operative across time and space, for example, can be directly confronted through the analysis of parallel cases that should display the same theoretical process (Skocpol and Summers 1980), thereby specifying a theory’s gen- erality and empirical scope. Comparative-historical analysis sometimes is directed toward developing explanations that ex- plicitly are ‘‘relative’’ to space and time (Beer 1963) or that represent historically or culturally ‘‘limited generalizations’’ (Joynt and Rescher 1960). Skocpol’s (1979) analysis of social revolutions in France, Russia, and China, for example, resulted in limited causal generalizations deemed valid for these three cases only. Exceptions to theoretical and empirical generality, moreover, can be con- ceptualized as deviant cases—anomalies or puz- zles. For example, Werner Sombart ([1906] 1976) posed the question ‘‘Why is there no socialism in the United States?’’ precisely because the United COMPARATIVE-HISTORICAL SOCIOLOGY 385 States, when contrasted to the European experi- ence and stacked up against available explanations for the development of class-conscious labor poli- tics, appeared both historically and theoretically anomalous. To explain such puzzles, the original theory is modified and new concepts and theories with greater explanatory power are formulated. The improved theory then serves as the new start- ing point for subsequent inquiry, so that cumula- tion of knowledge is facilitated (Stryker 1996). Thus historical patterns are comparatively situat- ed, the ‘‘inexplicable’’ residue of time and place therefore is potentially ‘‘explicable’’ (Sewell 1967), and sociological theory is further developed. ANALYTIC TYPES OF HISTORICAL COMPARISONS Contemporary comparative-historical research practice rests upon diverse, even contradictory, epistemologies and research strategies (Bonnell 1980, Skocpol 1984b, Tilly 1984; Ragin 1987; McMichael 1990; Kiser and Hechter 1991; Griffin 1992; Sewell 1996; Stryker 1996; Mahoney 1999). These can be initially grouped into two basic ap- proaches, labeled here ‘‘analytical formalism’’ and ‘‘interpretivism.’’ Each displays considerable in- ternal diversity, and the two can overlap and be combined in practice. Moreover, they can be syn- thesized in creative ways, thereby capitalizing on the strengths of each approach and reducing their respective weaknesses. The synthesis, ‘‘causal interpretivism,’’ is sufficiently distinct as to consti- tute a third approach to the analysis of compara- tive history. Analytically formal comparison. Formal com- parison conforms generally to conventional scien- tific practice in that causal explanation is the goal. It is therefore generally characterized by the devel- opment and empirical examination or testing of falsifiable theory of wide historical scope, by the assumption of the preexistence of discrete and identifiable cases, and by the use of formal logical or statistical tools and replicable analytic proce- dures. Historical narration and the ‘‘unities of time and place’’ (Skocpol 1984b, p. 383) are delib- erately replaced by the language of causal analysis. Analytic formal comparison can be used to gener- alize across time and space, to uncover or produce limited causal regularities among a set of carefully chosen cases, and to establish a theory’s scope conditions. There are two major procedural sub- types in this genre, statistical comparisons and formal qualitative comparisons. Statistical analyses of comparative-historical phe- nomena are logically and inferentially identical to statistical analyses of any other social phenomena. Thus, they rely on numerical counts, theoretical models, and techniques of statistical inference to assess the effects of theoretically salient variables, to test the validity of causal arguments, and to develop parsimonious, mathematically precise gen- eralizations and explanations. One important way in which the statistical method appears in com- parative-historical inquiry is in the form of ‘‘com- parative time-series’’ analysis, in which statistical series charting historical change are systematically compared across countries. Charles, Louise, and Richard Tilly (1978) and Bruce Western (1994), for example, first use statistical time-series proce- dures to map and explain historical variation in working-class activity within European nations. They then compare, either qualitatively (the Tillys) or quantitatively (Western), these national statisti- cal patterns to detect and explain historical differ- ences and similarities across these countries. The second major use of statistical procedures relies on quantitative data from many social units for only one or a few time points. Emphasis in this ‘‘cross-national’’ tradition (e.g., Chase-Dunn 1979; Jackman 1984; Korpi 1989) is on detecting causal generalizations that are valid for a large sample or even an entire population of countries. Though the results of such studies typically resemble a static, cross sectional snapshot of historical proc- ess, this analytic strategy sometimes is necessitated because complete time-series data do not exist for very many nations, especially those now undergo- ing economic and social development (e.g., Pampel and Williamson 1989). Due both to their data limitations and to their focus on statistical regu- larities and theory testing, cross-national studies typically slight historical processes and homogen- ize cultural differences across cases. The under- standing of cases as real social units deserving of explanation in their own right consequently is sometimes lost (Tilly 1984; Skocpol 1984b; Ragin 1987; Stryker 1996). In the 1990s, however, some cross-national statistical analysts, though continu- ing their search for general patterns, began to COMPARATIVE-HISTORICAL SOCIOLOGY 386 incorporate a more thorough appreciation of his- tory and cultural difference into their analyses (e.g., Western 1994). Formal qualitative comparison, by way of con- trast, views cases ‘‘holistically,’’ as qualitatively dis- tinct and independent units that cannot (or should not) be decomposed into scores on quantitative variables as in statistical analysis. This strategy adopts a ‘‘case-oriented’’ approach that pervades the entire research process (Ragin 1987). The explanation of a few carefully chosen cases, for example, generally is the rationale for and product of the analysis, and explicit strategies have been designed to select proper instances to be com- pared and analyzed (Przeworski and Teune 1970; Frendreis 1983; Lijphart 1971; Stryker 1996). De- tection of causal regularities is often inferred through the application of John Stuart Mill’s ([1843] 1967) inductive canons or ‘‘method of agreement’’ and ‘‘method of difference’’ to comparative data (Skocpol 1984b; Ragin 1987). Using the method of agreement, analysts select cases that have positive outcomes on the phenomenon under study but that differ on putative explanatory conditions. These cases are then compared to see what causal factor they share. Alternative explanations are eliminated if antecedent conditions representing those claims do not occur in all cases with positive outcomes. The ‘‘method of difference’’ is used to guard against false inferences adduced from the method of agreement. Here analysis is conducted with cases instancing both positive and negative outcomes but that are as similar as possible on the putative causal factors. The objective of Mill’s methods is to find the one condition that is pres- ent in all positive cases and absent in all negative cases (Skocpol 1984b; Ragin 1987). Mill’s methods are marred because they pre- suppose that one causal factor or configuration holds for all cases with positive instances. Histori- cal patterns displaying ‘‘causal heterogeneity’’ or ‘‘multiple causal conjunctures’’—two or more dis- tinct combinations of causal forces generating the same outcome (Ragin 1987)—are therefore logi- cally ruled out. This shortcoming results from the excessive weight Mill’s canons give negative cases: Because exceptions exist to almost any general process, the inability to find causal universals that are doubly confirmed by the twin logics of agree- ment and difference can rule out virtually any nontrivial explanation (Lijphart 1971; Ragin 1987; Mahoney 1999). However, Charles Ragin’s (1987) alternative comparative algorithm—’’qualitative comparative analysis’’ (QCA)—allows for the de- tection of causal heterogeneity in a large number of cases. QCA uses a data reduction strategy root- ed in Boolean algebra to search for similarities among positive instances and to exploit the infer- ential utility of negative cases. Negative or ‘‘devi- ant’’ cases may be explained by, or give rise to, an alternative causal process, but they are not allowed to invalidate all causal generalizations. Ragin ar- gues that QCA’s Boolean logic most closely ap- proximates the mode of reasoning—including the use of logically possible ‘‘historical hypotheticals’’ and ‘‘historical counterfactuals’’—employed by We- ber (1949) and Barrington Moore (1966) in their powerful but less formalized comparative-histori- cal studies. Formal qualitative comparison can provide both historically grounded explanation and theo- retical generalization. QCA is especially useful because it permits multiple causal configurations to emerge from comparative historical data and largely removes the inferential problems induced by the analysis of a small number of cases of unknown representativeness. Nonetheless, detrac- tors—who otherwise disagree about preferred re- search strategies—believe that formal comparison via either Mill’s methods or QCA often is fraught with hidden substantive assumptions, unable to exert sufficient analytical control over the multi- tude of competing explanations, and compromised by its roots in inductive logic (Burawoy 1989; Kiser and Hechter 1991). Moreover, formal compari- sons rest on a key assumption that is seriously challenged by proponents of holistic interpretive comparison—that the historical cases themselves are not systematically interrelated (Wallerstein 1974; McMichael 1990). Interpretive comparisons. . Interpretive com- parisons are most concerned with developing a meaningful understanding of broad cultural or historical patterns (Skocpol 1984b). Two very dif- ferent comparative logics, ‘‘holistic’’ and ‘‘indi- vidualizing,’’ are used to construct historical inter- pretations. Although neither logic relies extensively on formal analytic procedures, nor is geared to- ward testing theory, interpretive comparisons are not necessarily atheoretical or lacking in rigor. Indeed, concepts and theories, often of sweeping scope and grandeur, are extensively developed COMPARATIVE-HISTORICAL SOCIOLOGY 387 and deployed, but for the most part as interpretive and organizing frames, or as lenses through which history is understood and represented. Interpretive comparisons often are thought impressive, but sometimes of questionable validity due either to their self-validating logic or to their lack of explicit scientific criteria for evaluating the truth content of the interpretation (Bonnell 1980; Skocpol 1984b; Tilly 1984; Stryker 1996; Mahoney 1999). Holistic comparisons usually are tied to par- ticular theories and are used when a ‘‘social whole’’ such as a world system (Wallerstein 1974) is methodologically posited. Conceptualizing the en- tire world system in this manner suggests that there is but one theoretical unit of analysis, and that unit is the world system. What are considered to be separate ‘‘units of analysis’’ or ‘‘cases’’ in most comparative-historical strategies are, in the holistic methodological frame, really only interre- lated and interdependent historical realizations of a singular emergent process or social system. Wheth- er nation-states, regions, or cultures, these ‘‘mo- ments’’ therefore are not the discrete and inde- pendent units demanded by analytic formalism. Analysts using holistic historical comparisons in this manner often depend on an ‘‘encompassing’’ functional logic that explains similarities or differ- ences among parts of a whole by the relationship the parts have to the whole (Tilly 1984). Thus, Wallerstein’s (1974) comparisons explain the dif- ferential development of temporally and spatially specific (though interdependent) economic units in the world system—the core, periphery, and semi-periphery—by their differential positions and roles in the world economy. Such explanations are often circular in their reasoning and always diffi- cult to test, but they may serve as useful illustra- tions of the workings of a social whole or of the inner logic of a theory (Bonnell 1980; Skocpol 1984b). Philip McMichael (1990) suggests ‘‘incorpo- rated comparison’’ as an alternative to purge holis- tic comparison of its mechanistic and self-validat- ing logic. Here a kind of social whole is posited, but it does not preexist and regulate its parts, as does the world system. Instead, it is analytically ‘‘reconstituted’’ by conceptualizing different his- torical instances as interdependent moments, which, when cumulated and connected through time and space, ‘‘form’’ the whole as a general but empirically diverse historical process. Thus the very definition and selection of ‘‘cases’’ becomes the object of theorizing and research and not its point of departure or merely the vehicle conveying data for analysis. Karl Polanyi’s ([1944] 1957) analy- sis of the emergence and decline of laissez-faire capitalism is a compelling example of this form of holistic comparison. Individualizing interpretive analysts use histori- cal comparison to demonstrate the historical and cultural particularity of individual cases. Analysts in this tradition often choose research questions and cases on the basis of their recurrent moral and historical significance rather than scientific representativeness or comprehensiveness. They also tend self-consciously to eschew general theo- ry, quantification, and the methodology of causal analysis. Rather, interpretation is grounded in rich historical narration, in anthropological sensitivity to the import of cultural practice, in the culturally embedded meanings in social action, and in the use of persuasive concepts that crystallize or resonate with significant social values and themes (Bendix 1963; Geertz 1973; Bonnell 1980; Tilly 1984; Skocpol 1984b). Bendix’s ([1956] 1974) re- search on work and authority in industry is an exemplar of this strategy, and Daniel Goldhagen’s (1996) recent study, Hitler’s Willing Executioners, is another much more controversial example. Casual Interpretivism. Historical comparisons rooted in causal interpretivism synthesize aspects of both analytical-formal and interpretive-historical comparisons. Inspired in part by Weber’s (1949) formulation of ‘‘causal interpretation’’ (and an- thropologist Clifford Geertz’s [1980] similar idea of ‘‘interpretive explanation’’), this strategy is stamped by explicit causal reasoning, the potential for explanatory generality across comparable in- stances, and the use of methodological procedures allowing for strict replication, on the one hand, and attention to historical narrative, cultural par- ticularity, and subjective meaning, on the other. Causal interpretivism has been most fruitfully developed and applied in the analysis of historical narratives (Sewell 1996; Griffin 1992, 1993; Quadagno and Knapp 1992; Somers 1998). Narratives are ‘‘sequential accounts’’ organizing information in- to ‘‘chronological order to tell stories about what happened. . .’’ and why it happened as it did, and, as such, are ‘‘tools for joining sequentiality, contin- gency, and generalizability’’ (Stryker 1996, p.305, 307). Narrativists conceptualize historical time so COMPARATIVE-HISTORICAL SOCIOLOGY 388 that it is ‘‘eventful:’’ Any given moment in a histori- cal chain of unfolding sequences is both a reposi- tory of past actions and a harbinger of future possibilities (Thompson 1978). Temporal order and the causal relationships among actions that make up events therefore become the major ob- ject of inquiry in comparative narrative analysis. Narrative focuses squarely on the import of human agency in reproducing or changing socie- tal arrangements, thereby complementing the at- tentiveness comparative-historical sociologists have traditionally given social structural constraints and opportunities (Stryker 1996). Channeling analyti- cal attention in this fashion directs narrativists both to transformative historical happenings (the French Revolution, for instance [Sewell 1996]) and to the development and deployment of decid- edly temporal concepts, such as path dependence, sequential unfolding, temporally cumulative cau- sation, and the pace of social action (Abrams 1982; Aminzade 1992). The structure of action under- pinning particular historical narratives, moreover, can also be strictly compared with an eye toward both showing general patterns across events and individual exceptions to those generalizations (Abbott 1992; Griffin 1993). Dietrich Rueschemeyer and John Stephens (1997), for example, demon- strate how ‘‘eventful time, including the order and sequence of key actions, can both be incorporated into causal generalizations for such large scale processes as democratization and capitalist eco- nomic development and [be] exploited to ascer- tain where those generalizations break down. Comparative narrativists have developed a va- riety of procedures to enhance the theoretical payoff and replicability of their research: (1) event- structure analysis (Griffin 1993), which allows ex- plicit codification of reasons for inferences and for cross-level generalization; (2) semantic grammar analysis, which uses linguistic rules to convert text, such as newspaper accounts of strikes In Italy, into numbers for subsequent statistical analysis (Franzosi 1995, 1998); and (3) systematizing electronic means to collect, store, code, and analyze diverse types of historical texts, from newspaper articles to court opinions and legislative hearings (Stryker 1996; Pedriana and Stryker 1997). Robin Stryker (1996) has also developed the useful notion of ‘‘strategic narrative’’ as a guide to case selection in compara- tive-historical analysis: Strategic narrative suggests that some historical events and ways of construct- ing stories will promote theory-building more than will others, thus facilitating cumulation of knowledge. Regardless of precisely how analytical formal- ism is incorporated, unpacking a narrative and reconstituting it as an explicit causal account— that is, comprehending and explaining the logical within the chronological, and the general within the particular—often requires that analysts imagi- natively reconstruct participants’ cultural under- standings (interpretation), as well as systematically harness theoretical abstractions, comparative gen- eralizations, and replicable research methods. In effect, then, analysts explain because they are com- pelled to interpret, and they interpret because causal explanation is demanded (Beer 1963; Grif- fin 1993; Mahoney 1999). METHODOLOGICAL ISSUES AND DIFFICULTIES Though comparative-historical analysis is neither necessarily cross-national or cross-cultural, nor al- ways confronting the same obstacles as narrative history, it does share many of the methodological problems (and solutions) and dilemmas tradition- ally associated with both types of research. These include, among others: (1) defining and selecting comparable analytical units; (2) case interdepend- ence; (3) the nonrepresentativeness of cases; (4) determining conceptual equivalence and meas- urement reliability and validity across time and space; (5) the paucity of data, especially that which is quantitative, over long periods of time, and for newly emerging nations; (6) the selectivity and general unsoundness of the historical record; (7) the use of spatially and temporally aggregated data, and, more generally, the distance between what can be collected and systematically measured and what the theory or research question actually calls for; and (8) fruitful ways to wed historical narration and cultural specificity, on the one hand, to the development of general sociological theory and cumulative, replicable results, on the other. Some of these difficulties especially plague analyti- cally formal comparisons (e.g., the artificiality and interdependence of cases; the paucity of systemat- ic, quantifiable data at the proper theoretical level of analysis; and the excessive generality at the cost of important historical and cultural specificity); COMPARATIVE-HISTORICAL SOCIOLOGY 389 others haunt with more force interpretive com- parisons (e.g., nonrepresentative cases; analytical looseness and non replicability; and excessive par- ticularity at the expense of generalization and theoretical development). Granting their very real import, these difficul- ties are not normally intractable. As we have shown, methodologically self-conscious comparative-his- torical scholars, both qualitative and quantitative, have devised strategies to: construct and select the most relevant cases for analysis; exploit cross-level data (e.g., within and between nation-states) and make causal inferences across levels of analysis; guard against logically false or self-validating infer- ences; infuse the analysis of historical narrative with greater theoretical and analytical rigor; and increase the number and representativeness of their cases. They have also devised or imported useful ways to ensure maximum measurement equivalence across cultures; sample historical rec- ords; estimate data missing from statistical series and to correct for truncated data; capitalize on case interdependence with new statistical meth- ods; historically ground time-series analysis; etc. (see Bloch [1928] 1969; Carr 1961; Przeworski and Teune 1970; Zelditch 1971; Tuma and Hannan 1984; Skocpol 1984b; Ragin 1987; Kohn 1989; Isaac and Griffin 1989; McMichael 1990; Kiser and Hechter 1991; Griffin 1993; Western 1994; Deane, Beck, and Tolnay 1998). Some problems, admittedly, have no satisfac- tory solution, and nothing can compensate for the utter dearth of valid information on particular happenings or variables. This, though, is hardly different from any other form of social research. The litany of methodological difficulties discussed above, in fact, afflict all social research. Survey analysts, for example, deal with questionnaire re- sponses of dubious accuracy and unknown mean- ing taken from geographically and temporally lim- ited samples, and scholars working with institutional records of any sort must deal with information collected by institutionally self-interested actors. It is important to recognize that although comparative-historica