National health care goals generally include providing broad access to appropriate amounts of high-quality health care at appropriate cost to the ultimate payers. Yet all countries, regardless of how they deliver and finance health care, struggle to achieve a sustainable balance among the implicit tradeoffs. Does this struggle stem from the limited scope for competition in health care or from information asymmetries? Or does it simply reflect the inherent difficulty of measuring health care output and quality? Alternatively, does it result from deep-seated human behavior - a tendency for individuals to postpone saving, say, or for the utility of health care to shift over time? What are the implications for reform?
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