Handbook of International Health Care Systems PDF

Preface

This book project was initiated at a time when rising expenditures for health care were of great concern and a precipitating factor in calls for health care reform in the United States. Many other developed countries that had experienced increases in health care expenditures also viewed these events with increasing alarm.

The concern over rising costs has prompted governments to examine the underlying factors and to take action. The role of government in health care usually incorporates two major dimensions: the financing of health care and other social programs, and the determination, to some extent, of how the delivery system is organized. Thus, government action occurs most often in the form of restructuring the health care system or altering the mechanisms for financing health care. How extensive this role is varies with the history and culture of each nation, which influence the philosophy and values concerning the appropriate parameters for government involvement in the affairs of its citizens.

The government's ability to finance services is limited by its ability to raise funding through taxation and then to manage and allocate these funds effectively and efficiently. In developed countries, taxpayers attempt to determine their willingness to be taxed through their voting behaviors for political parties and candidates with whose promised positions on taxation and government spending they agree. Voters who favor government spending on particular programs are usually willing to be taxed for the provision of those programs. Voters who are concerned with containing government spending are less likely to be willing to pay taxes, let alone tax increases.

As expenditures for health care have steadily risen, voters and governments have had to become more aware of the tradeoffs between spending for health care and spending for other desired programs, as well as the impact of reducing spending on health care. While the extent of government involvement in the financing and organization of health care does vary among countries, these concerns over steadily rising costs are common.

The intent of this book is to examine what various countries have done in the area of health care financing, what the role of the national government has been, how the health care system is financed, how the providers are organized and structured, and whether these activities have been successful in addressing rising costs and expenditures. The book is intended to provide policy makers, researchers, and students of health care policy and administration with valuable information about various health care systems.

This book is dedicated to the memory of Dr. Sharon M. McManus, coeditor of the book. Dr. McManus was a scholar and an advocate for her students. She will be missed by all who came in contact with her. Determined to complete this book in the memory of Dr. McManus, I invited a dear colleague, Dr. Terry Wimberley, to fill the void left by Dr. McManus. Without his participation, the book would not have been finished by this time. I appreciate his hard work and his willingness to join this book project.

I also appreciate the patience, understanding, and cooperation of all contributors of this book, particularly those who completed their chapters very early and had to spend time to revise and update their early drafts. Special thanks go to Dr. Jack Rabin, editor of the Public Administration and Public Policy series, and Marcel Dekker, for accepting the original proposal and offering valuable encouragement. I am especially grateful for the professional assistance of Ms. Paige Force, Production Editor, and other staff members at Marcel Dekker, Inc.