Health Care Reforms across the World

Abstract

Most international comparative research focuses on the United States and other large industrialized nations in Europe and North America, and only exceptionally1 on smaller ones. Yet, outside China and India, the vast majority of the world’s population lives in smaller and medium-sized nations. In fact, as this contribution shows, small- and medium-sized countries provide interesting “laboratories” of policy innovation. Those laboratories can be enlightening for anyone interested in issues of cost control, universal access to health care services, consumer choice, fair distribution of the financial burden of medical treatment, and related issues in health policy. Time and again, studies show that in those dimensions, the United States has not done well compared to other nations: we spend much more and have more advanced medical technologies and new drugs than anyone else, but we do not get enough value for money. Access to health care is highly fragmented and unevenly distributed, with more than twenty-five million, or about 10 percent of the population, uninsured and another ten million or so underinsured.2 In fact, maternal and child mortality is much higher in the United States than in nations with comparable income levels, and the average life expectancy of Americans has even dropped in the last few years. This assessment of the health reforms in other countries aims to broaden our horizon to include experiences abroad.