HEALTH-CARE REFORM - INFORMING DIFFICULT CHOICES

During the last decade, policy makers in a large number of countries h ave attempted various reforms of their health care systems. Health car e reform has been described as a 'global epidemic' (Klein, 1993). Al h ealth care reforms consist of very complex policy choices, some of whi ch are examined in this article. After an introductory exploration of ideological issues, the objectives of health care reformers are consid ered. Three major policy objectives of health care reform are examined : cost containment; efficiency; and, equity. Three types of reform whi ch have been advocated are also considered: public planning; market re gulation; and provider-advocated reforms such as a 'basic package' wit h copayments and alternative means of finance. Finally, appropriate fe atures of efficient health care reform are suggested, addressing expli cit policy goals.