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


  • Tenbensel, Tim
  • Eagle, Samantha
  • Ashton, Toni


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.

Suggested Citation

  • Tenbensel, Tim & Eagle, Samantha & Ashton, Toni, 2012. "Comparing health policy agendas across eleven high income countries: Islands of difference in a sea of similarity," Health Policy, Elsevier, vol. 106(1), pages 29-36.
  • Handle: RePEc:eee:hepoli:v:106:y:2012:i:1:p:29-36 DOI: 10.1016/j.healthpol.2012.04.011

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    References listed on IDEAS

    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, vol. 5(03), pages 269-293, July.
    2. Immergut, Ellen M., 1990. "Institutions, Veto Points, and Policy Results: A Comparative Analysis of Health Care," Journal of Public Policy, Cambridge University Press, vol. 10(04), pages 391-416, October.
    3. Adam Wagstaff, 2010. "Social health insurance reexamined," Health Economics, John Wiley & Sons, Ltd., vol. 19(5), pages 503-517.
    4. Christoffer Green-Pedersen, 2007. "The Growing Importance of Issue Competition: The Changing Nature of Party Competition in Western Europe," Political Studies, Political Studies Association, vol. 55, pages 607-628, October.
    5. repec:aph:ajpbhl:2003:93:3:383-388_6 is not listed on IDEAS
    6. 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, vol. 5(03), pages 251-267, July.
    7. Kittel, Bernhard & Obinger, Herbert, 2002. "Political parties, institutions, and the dynamics of social expenditure in times of austerity," MPIfG Discussion Paper 02/1, Max Planck Institute for the Study of Societies.
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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, vol. 99(C), pages 9-17.
    2. repec:eee:hepoli:v:121:y:2017:i:8:p:853-861 is not listed on IDEAS
    3. Matthias Pelster & Vera Hagemann & Franziska Laporte Uribe, 2016. "Key Aspects of a Sustainable Health Insurance System in Germany," Applied Health Economics and Health Policy, Springer, vol. 14(3), pages 293-312, June.


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