Abstract
Two recently published books on health policy reform, one on France by William Genieys and Mohamed-Saïd Darviche, and the second on the USA by Genieys alone, mark the latest phase of a research enterprise underway for the better part of three decades. By exploring the role of elites within the state, with a particular focus on experts and senior civil servants, these studies advance the understanding of the practical dynamics of policy reform in complex institutional settings. Taken together, the two studies also provide a significant contribution to the comparative study of public policy. Their focus on key actors allows both better understanding of the role played by national institutional opportunity structures, and a constructive critique of “institutionalism.”