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Comparing health policy agendas across eleven high income countries: Islands of difference in a sea of similarity


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  • Tenbensel, Tim
  • Eagle, Samantha
  • Ashton, Toni
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    Does the way in which health systems are financed influence whether health policymakers are more or less interested in accessible and equitable health services? Are social democratic governments more interested in primary health care reform than conservative governments? Have particular domains of health policy really become more important over the past decade across a range of countries? In this exploratory article, we investigate the similarities and differences in patterns of attention in health policy in eleven high income countries using data from the Health Policy Monitor database from 2003 to 2010. Our study suggests significant ‘islands of difference’ in an overall ‘sea of similarity’ between the health policy agendas of the selected countries. The key findings are: (i) that improving population health outcomes is more likely to be on the agenda under tax-based systems and when centre-left parties are dominant in government; (ii) health systems funded through social insurance are more preoccupied with efficiency and cost-containment than tax-funded systems; (iii) the political complexion of governments is not a major factor shaping health policy agendas; and (iv) since 2003 there has been an increasing interest in initiatives that address public health concerns, access and equity, and population health outcomes.

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    Bibliographic Info

    Article provided by Elsevier in its journal Health Policy.

    Volume (Year): 106 (2012)
    Issue (Month): 1 ()
    Pages: 29-36

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    Handle: RePEc:eee:hepoli:v:106:y:2012:i:1:p:29-36

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    Keywords: Health policy agenda; Health system financing; Health outcomes; Access/equity; Efficiency/cost-containment; Quality; Health services;


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    1. Or, Zeynep & Cases, Chantal & Lisac, Melanie & Vrangbæk, Karsten & Winblad, Ulrika & Bevan, Gwyn, 2010. "Are health problems systemic? Politics of access and choice under Beveridge and Bismarck systems," Health Economics, Policy and Law, Cambridge University Press, Cambridge University Press, vol. 5(03), pages 269-293, July.
    2. Wagstaff, Adam, 2007. "Social health insurance reexamined," Policy Research Working Paper Series 4111, The World Bank.
    3. Christoffer Green-Pedersen, 2007. "The Growing Importance of Issue Competition: The Changing Nature of Party Competition in Western Europe," Political Studies, Political Studies Association, Political Studies Association, vol. 55, pages 607-628, October.
    4. Bevan, Gwyn & Helderman, Jan-Kees & Wilsford, David, 2010. "Changing choices in health care: implications for equity, efficiency and cost," Health Economics, Policy and Law, Cambridge University Press, Cambridge University Press, vol. 5(03), pages 251-267, July.
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    Cited by:
    1. Kringos, Dionne S. & Boerma, Wienke G.W. & van der Zee, Jouke & Groenewegen, Peter P., 2013. "Political, cultural and economic foundations of primary care in Europe," Social Science & Medicine, Elsevier, Elsevier, vol. 99(C), pages 9-17.


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