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Health Systems and Reform: Comparative International Perspectives

Course Description

All health systems, in the industrialized world, grapple with problems of cost, access, equity and quality of health care; and the trade-offs among these objectives. Reforms based on promoting markets, managed competition, public contracting, improved management, and changing financial incentives are some important issues under discussion in most nations.

This seminar relies on public policy analysis and political economy perspectives to compare health systems in wealthy nations and analyze efforts at health care system reform. The readings, lectures, and class discussions will make students more knowledgeable about policy options and policy changes in different countries. I will also provide opportunities for students to pursue their individual research interests by comparing two relatively wealthy nations of their choice.

The seminar begins with an introduction to health care system performance. Next, we focus on theories, concepts and fads in health care reform, including managed competition, primary health care reform, and universal health coverage. We review the controversial WHO approach to health system performance, the contributions of the Commonwealth Fund’s international health survey data, and the extent to which existing metrics are useful for monitoring the health care reform process. We then examine the politics of health system reform efforts in selected nations – France, Canada, the United Kingdom and China.


CORE-GP.1022, HPAM-GP.1830 or HPAM-GP.2836, HPAM-GP.4830

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