Health insurance reform in Washington State: The interaction of bounded instability with public policy choices

This study profiles an attempt to implement comprehensive health insurance reforms in the state of Washington. Through a case history outlining the work of the Washington Health Services Commission, questions are asked about the nature of change in government-sponsored processes. Scientific theories of chaos and complexity are outlined, and analogies to extend application of the theories to human behavior in organizational settings such as the one profiled are suggested. Analytic induction is the methodological framework for the analysis and participant observation is the form of information gathering employed.