European national policy-makers broadly agree on the core objectives that
their health care systems should pursue. The list is strikingly straightforward:
universal access for all citizens, effective care for better health outcomes, efficient
use of resources, high-quality services and responsiveness to patient concerns.
It is a formula that resonates across the political spectrum and which, in
various, sometimes inventive configurations, has played a role in most recent
European national election campaigns.
Yet this clear consensus can only be observed at the abstract policy level.
Once decision-makers seek to translate their objectives into the nuts and
bolts of health system organization, common principles rapidly devolve into
divergent, occasionally contradictory, approaches. This is, of course, not a
new phenomenon in the health sector. Different nations, with different histories,
cultures and political experiences, have long since constructed quite
different institutional arrangements for funding and delivering health care
services.
The diversity of health system configurations that has developed in response
to broadly common objectives leads quite naturally to questions about the
advantages and disadvantages inherent in different arrangements, and which
approach is ‘better’ or even ‘best’ given a particular context and set of policy
priorities. These concerns have intensified over the last decade as policy-makers
have sought to improve health system performance through what has become
a European-wide wave of health system reforms. The search for comparative
advantage has triggered – in health policy as in clinical medicine – increased
attention to its knowledge base, and to the possibility of overcoming at least
part of existing institutional divergence through more evidence-based health
policy-making.
The volumes published in the European Observatory series are intended to
provide precisely this kind of cross-national health policy analysis. Drawing
on an extensive network of experts and policy-makers working in a variety of
academic and administrative capacities, these studies seek to synthesize the
available evidence on key health sector topics using a systematic methodology.
Each volume explores the conceptual background, outcomes and lessons
learned about the development of more equitable, more efficient and more
effective health care systems in Europe. With this focus, the series seeks to
contribute to the evolution of a more evidence-based approach to policy formulation
in the health sector. While remaining sensitive to cultural, social
and normative differences among countries, the studies explore a range of
policy alternatives available for future decision-making. By examining closely
both the advantages and disadvantages of different policy approaches, these
volumes fulfil a central mandate of the Observatory: to serve as a bridge
between pure academic research and the needs of policy-makers, and to stimulate
the development of strategic responses suited to the real political world in
which health sector reform must be implemented.
The European Observatory on Health Care Systems is a partnership that
brings together three international agencies, three national governments, two
research institutions and an international non-governmental organization. The
partners are as follows: the World Health Organization Regional Office for
Europe, which provides the Observatory secretariat; the governments of Greece,
Norway and Spain; the European Investment Bank; the Open Society Institute,
the World Bank; the London School of Hygiene & Tropical Medicine and the
London School of Economics and Political Science.
In addition to the analytical and cross-national comparative studies published
in this Open University Press series, the Observatory produces Health
Care Systems in Transition Profiles (HiTs) for the countries of Europe, the
Observatory Summer School and the Euro Observer newsletter. Further information
about Observatory publications and activities can be found on its web
site at www.observatory.dk.