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There is a tendency in the new institutionalist literature to equate institutional inertia with stasis and 'no-change'. Using case studies from the international telecommunications regime and the German health care system, the paper tries to show that this equation is wrong. Inertia does not necessarily prevent institutional change. It can interfere with the replacement of old institutions, but it is compatible with other forms of institutional transformation. Inert structures can be patched updoi:10.1097/00004356-198912000-00006 fatcat:gahqv3z5nzbofetb3bg6dxew4i