LEARNING FROM OTHERS - SHALL THE LAST BE THE FIRST

The cross-national exchange of ideas and experience in health care ref orm has, in recent years, reached epidemic proportions. Taking stock o f this suggests the need for critical. caution. The various participan ts in the process have different motives; models may be exported befor e they have been fully tested; information may be sought chiefly as po litical ammunition; and selective perception often distorts the eviden ce. A mon helpful approach might be to concentrate on evaluating the e xperience of countries over time, rather than concentrating on the lat est fashionable panacea, and to focus more on the process of introduci ng change.