Reforming Health Care in Seven European Nations

Abstract

Prologue: Most health care systems the industrialized world over share a number of common characteristics: they insure virtually all of their citizens, they allow patients to select their own physician, and they also constrain medical expenditures at some level that is deemed broadly acceptable to the polity. They also cope with a common reality: they operate in a state of continuous change, striving to adjust to the economic, political, and social demands of the moment. In this essay, Jeremy Hurst provides a glimpse of the nature of change in the 1980s in seven West European nations, all of which have pretty much stabilized the growth of their health care spending to a level that is commensurate with the growth of their national economies. Hurst is a senior economic adviser in the Department of Health, which oversees Britain's National Health Service. He was one of the early pioneers among a small group of economists, health services researchers, and other analysts who have studied the health care system...