Abstract

Health care reform in the industrialized countries, enacted during the last two decades, is entering a new phase of consolidation and further development, now extending to the less developed countries. This marks a significant element of the more general phenomenon commonly referred to as "globalization." This paper examines how the processes of institutional reform and adjustment have been and are being managed, toward the projected end of a global regulatory regime governing trade in health services. Elaborated are the complex interplays between local and international actors, ideologies and technologies. The paper concludes by forecasting the likely trajectory of future institutional adjustments based on an extrapolation of the foregoing.

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