The endeavor to achieve UHC is known to be sensitive to the historical and political alterations, which can largely shape and affect this endeavor in many countries.
These political alterations can affect the endeavor of UHC by limiting it to a stiff and rigid trajectory that might end up in shortage of the main objective.
In contemporary American politics, Democrats and Republicans have become increasingly polarized along ideological lines.
This division is especially apparent in the debates surrounding the possibility of universal health care given the passage of the new health care reform bill this past year.
In attempts to understand and depict these trajectories, path dependence theory emerges as a potential explanatory tool on how historical events can affect the present and the future.
Universal health coverage, political transformations, and path dependence are the three big pillars which this article studies and connects in the context of the Egyptian health system.Perhaps the archetypical example of path dependence theory is the persistence of the QWERTY keyboard in new technologies despite the emergence of newly technically superior alternatives (5). The orthodox simple explanation of the path-dependent processes is that “the social world often follows a particular trajectory: an open period during which there are a number of plausible alternatives, a critical juncture where contingent events result in one of these alternatives being selected, and then feedback that constrains actors to keep to that particular path” (6).Another definition that emphasizes the surroundings of the action or decision is that path dependence “is a specific form of complex dynamics: It provides an analytical framework to explain and assess the ever-changing outcomes of the combination of and interaction amongst factors of continuity/discontinuity, growth and development, hysteresis and creativity, routines and ‘free will’, which all characterize economic action in a dynamic perspective that is also able to appreciate the role of historic time” (2, 4).Path dependence theory is used to describe and explain the dynamics of such processes by incorporating the temporal dimension into the process theory (3).Path dependence theory has been used in many domains, such as technological development, economics, political sciences, national corporate governance systems, urbanism, tourism, industrial clusters, management operations, scientific knowledge, export behavior, and innovation systems, and recently has been introduced to the health policy field (4).We also found that preferences for rational thinking styles and maintained executive functioning were associated with liberal ideology in older adults.Moreover, rational processing and executive function were uniquely correlated with support for universal health care in addition to party affiliation.These challenges subsequently had a negative impact on the accessibility of the healthcare services.Universal health coverage (UHC), the big term in health policy, is the ultimate aim for several countries and intergovernmental organizations such as the World Health Organization.Another important definition for path dependence is that it refers to “a property of contingent, non-reversible dynamic processes, including a wide array of processes that can be properly be described as evolutionary” (7).According to Mahoney (8), path dependence is a set of consecutive events, which start unfolding from a key choice milestone or critical juncture.