Exploring the Political and Economic Dynamics of Health Policy

This paper extends recent systems approaches to US health reform to the international sphere and explicitly represents the political and economic dimensions of health policy. It overlays the worldviews of health care as an industry with user as consumer, a profession with user as patient, and a societal right with user as citizen. Within this framework it discusses the extent and interaction of hierarchical, market and network control mechanisms on key system performance goals. A method for comparing these interactions among health institutions and control mechanisms is proposed. This work can inform simulating international comparisons of health systems evolution and explicitly representing their ‘strife’ of less tangible political and vested interests, in order to understand, plan and test the acceptability of proposed health reforms in various countries and regions.