Comparative Perspectives and Policy Learning in the World of Health Care

Posted: 10 Oct 2005  

Theodore R. Marmor

Yale School of Management

Richard B. Freeman

National Bureau of Economic Research (NBER); University of Edinburgh - School of Social and Political Studies; Harvard University; London School of Economics & Political Science (LSE) - Centre for Economic Performance (CEP)

Kieke Okma

Independent

Abstract

The main point of this article is to explore the methodological questions raised by weaknesses in international comparative work in the field of health policy. The core question is how competent learning from one nation to another can take place. The article argues that there is a considerable gap between the promise and the actual performance of comparative policy studies. Misdescription and superficiality are all too common. unwarranted inferences, rhetorical distortion, and caricatures - all show up too regularly in comparative health policy scholarship and debates.

The article first describes the context of the health and welfare state reform debates during the past three decades. In almost all industrialized democracies, rising medical expenditures exacerbated fiscal concerns about the affordability of the mature welfare states. In reaction to pressure for policy change in health care, policy makers looked abroad for promising solutions of domestic problems. The following section takes up the topic of cross-national policy leaning. Then, it critically reviews recent debates about health care reforms and addresses the purposes, promises and pitfalls of comparative study in health policy. The next section categorizes existing comparative health policy literature to highlight the character, possibilities and limits of such work. The concluding section returns to the basic theme: the real promise of comparative scholarship and the quite mixed performance to date.

Suggested Citation

Marmor, Theodore R. and Freeman, Richard B. and Okma, Kieke, Comparative Perspectives and Policy Learning in the World of Health Care. Journal of Comparative Policy Analysis, 2005. Available at SSRN: https://ssrn.com/abstract=824126

Theodore Richard Marmor (Contact Author)

Yale School of Management ( email )

135 Prospect Street
P.O. Box 208200
New Haven, CT 06520-8200
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203-432-3238 (Phone)

Richard B. Freeman

National Bureau of Economic Research (NBER) ( email )

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Cambridge, MA 02138
United States
617-868-3900 (Phone)
617-868-2742 (Fax)

University of Edinburgh - School of Social and Political Studies ( email )

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United Kingdom

Harvard University ( email )

Littauer Center
Cambridge, MA 02138
United States
617-868-3900 (Phone)

London School of Economics & Political Science (LSE) - Centre for Economic Performance (CEP) ( email )

Houghton Street
London WC2A 2AE

Kieke Okma

Independent

No Address Available

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