This issue of the International Journal of Healthcare Finance and Economics features eight articles evaluating different provider payment methods in comparative international perspective, with authors from Hungary, China, Thailand, the US, Switzerland, and Canada. These contributions illustrate how the array of incentives facing providers shapes their interpersonal, clinical, administrative, and investment decisions in ways that profoundly impact the performance of health care systems. Taken as a whole, the articles show that in addition to the specifics of the reimbursement or remuneration scheme for individual providers and provider organizations, other factors matter—including ownership, allocation of control rights (such as in public-private partnerships), and expectation of a bail-out (soft budget constraints). All of these facets of payment and accountability systems shape the quality and efficiency of service delivery. The collection leads off with a study by Janos Kornai, one of the most prominent scholars of socialism and post-socialist transition, and the originator of the concept of the soft budget constraint. Kornai’s paper examines the political economy of why soft budget constraints appear to be especially prevalent among health care providers, compared to other sectors of the economy. He gives examples from Hungary and Italy, and discusses a broad range of factors including government financing, patient moral hazard, provider altruism for patients and emphasis on new technologies, managers’ political connections, and fiscal relations between central and local governments. Kornai concludes that the soft budget constraint phenomenon is not confined to socialist systems, post-socialist economies, or government-owned providers; rather, soft budget constraints inevitably develop in the hospital sector, even in capitalist market economies. Two other papers in the issue take up the challenge of empirically identifying the extent of soft budget constraints among hospitals and their impact on safety net services,