For more information, contact:
Jon Gardner, Health Affairs, 301-656-7401

For immediate release
Tuesday, March 14, 2002

One World, Many Health Care Challenges
Health Affairs Special Issue Profiles International Health System Change

BETHESDA, Md.–Whether to allow private insurers to cover health care for Canadians and how to balance competition and centralized control in Britain's national health system are issues debated in a special international edition of the journal Health Affairs.

The May/June edition of Health Affairs reports on topics confronting national health care systems from the Americas to Africa to the South Pacific. It kicks off with a profile of the challenges facing Canada's national health system. University of Toronto health care policy scholar Carolyn Tuohy debates the choices facing the Canadian health care system: How to restructure the publicly financed system under demands for higher payments to providers and for more benefits for citizens.

From North America, the issue crosses the Pacific Ocean to profile patient protection in New Zealand. Ron Paterson, New Zealand's health and disability commissioner, describes the country's patients' grievance system imposed in 1996. Although he makes no conclusions about its success in improving outcomes, he does note that it is an important complement to New Zealand's no-fault scheme for compensating the victims of medical errors.

The issue moves to the home of the British Commonwealth to discuss reform of the United Kingdom's National Health Service. British economist Julian Le Grand describes how the government of Prime Minister Tony Blair has reversed some of the market-based models of the previous administration in favor of collaboration but now is moving steadily toward a more centrally controlled system. Le Grand, however, cautions against too much central control, and writes that competitive pressures may be necessary to keep the system efficient.

The international theme closes with two cross-national comparisons. Princeton University economist Uwe Reinhardt and his colleagues analyze health spending statistics in the countries of the Organization for Economic Cooperation and Development. Harvard University public opinion expert Robert Blendon then compares attitudes toward the health care system in five English-speaking countries. The survey finds a growing dissatisfaction with health care in all five countries, with the dissatisfaction highest among those with below-average incomes.

Health Affairs, published by Project HOPE, is a bimonthly, multidisciplinary journal devoted to publishing the leading edge in health policy thought and research. Copies of the journal are free to interested members of the press. Address inquiries to Jon Gardner at Health Affairs, 301-656-7401, ext. 230, or via e-mail,

This issue was published with the generous support of the Commonwealth Fund.


©2002 Project HOPE–The People-to-People Health Foundation, Inc.