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Frontmatter -- Contents -- Acknowledgments / Hollingsworth, J. Rogers / Hage, Jerald / Hanneman, Robert A. -- 1. Theoretical Perspectives: An Introduction -- 2. Four National Medical Systems -- 3. The Costs of Care -- 4. Improving Levels of Health -- 5. Medical Innovation -- 6. Social Efficiency -- 7. Equal Care and Unequal Health -- 8. State Intervention versus Privatization -- Appendix 1. Sources for Tables -- Appendix 2. Index Construction -- Appendix 3. Regression Analysis -- Bibliography -- Index

Das Papier untersucht die Genese und Institutionalisierung der Fraunhofer-Gesellschaft als Organisation für die Vertragsforschung im außeruniversitären Forschungssystem der Bundesrepublik. In der Folge interorganisatorischer Domänenkonf likte wurde die Gesellschaft in der Mitte der fünfziger Jahre zunächst aus der Forschungsfinanzierung des Bundes ausgeschlossen. Im Interesse ihrer Überlebenssicherung nutzte sie die Gelegenheit, mit Unterstützung vor allem durch das Land Baden-Württemberg in der industriellen Vertragsforschung tätig zu werden, drohte mit diesem Konzept aber an Schwellenproblemen zu scheitern. Militärische Forschungsmittel ermöglichten es der Gesellschaft, diese Schwellenprobleme zu überwinden und ein moderates, aber stabiles Wachstum der zivilen Vertragsforschung herbeizuführen. An diese Entwicklung knüpfte die Reform der Gesellschaft durch die Bundesregierung und ihr Ausbau zur Trägerorganisation in der angewandten Forschung am Anfang der siebziger Jahre lediglich an. Das "Modell Fraunhofer-Gesellschaft" beruht auf institutionellen Strukturen, die sich in einem Prozeß von situativ ineinandergreifenden Verkettungen und einer daraus resultierenden pfad-abhängigen Wachstumsdynamik der Vertragsforschung herausgebildet haben. ; This paper examines the genesis and institutionalization of the Fraunhofer-Gesellschaft (FhG) as an organization for contract-research in the West-German research system outside the universities. As a result of interorganizational conf licts of domain in the midf ifties, the FhG was for the time being excluded from state-funding. The society survived by taking the chance of conducting contract-research subsidized mainly by Baden-Württemberg. The concept of contractresearch, however, was on the brink of failure due to threshold-problems. Military research funds made it possible for the FhG to cross these threshold-problems and to induce a moderate but stable growth of civilian contract-research. The reformation of the society by the federal government and its extension to the mainly responsible institution in the field of applied research during the early seventies only picked up this development. The "Modell Fraunhofer-Gesellschaft" is based on institutional structures which emerged in a process of situative "lock-ins" leading to a pathdependend increase of contract-research.

"This paper is a small part of a much larger historical and cross-national research agenda in which the author has been engaged for more than a decade. The agenda has confronted two major problems: (1) How does the institutional environment in which actors are embedded constrain their behavior and (2) how do the structure and culture of organizations facilitate or hamper their innovativeness. The paper addresses the problem of how the structure and culture of research organizations influence the creation of fundamental new knowledge. More specifically, the paper is part of a research project which is concerned with the question of why research organizations varied in their capacity to make major breakthroughs in biomedical science in the twentieth century. The perspectives that have been useful in shaping this project have come from diverse sources - the literatures on national systems of innovation, on organizational innovation, on evolutionary economics, on organizational capabilities, and literatures in the history and sociology of science. The ideas in these literatures have been refined and extended through many dozen historical case studies of major discoveries, which my colleagues and I have conducted in approximately 200 research organizations in twentieth-century Britain, France, Germany, and the United States. The theoretical framework of the paper is used to analyze the structure and culture of the one research organization which had more major breakthroughs in biomedical science than any other in the twentieth century: the relatively small Rockefeller University in New York City. Hopefully, this case study will shed light on the kinds of organizational strategies, structure and culture which facilitate the creation of fundamental new knowledge in very hybrid fields of science." (excerpt)