Required Reading

Chan, K. (2009). Introduction to comparative health systems. Global Health Education System. Retrieved from

Saltman, R. B. (2012). The role of comparative health studies for policy learning. Health Economics, Policy, and Law. 7(1). 11-13. Available in the Trident Online Library. PLEASE SEE ATTACHMENT!!

Schneider, E. C., Sarnak, D. O., Squires, D., Shar, A., & Doty, M. M. (2017). Mirror, mirror 2017: International comparison reflects flaws and opportunities for better U.S. health care. Commonwealth Fund. Retrieved from:

Shi, L. (2014). International health policymaking. In Introduction to health policy, pp. 74-96. Chicago: Health Administration Press. Available in the Trident Online Library. PLEASE SEE ATTACHMENT

Shi, L. (2014). International health policy issues. In Introduction to health policy, pp. 150-182. Chicago: Health Administration Press. Available in the Trident Online Library. PLEASE SEE ATTACHMENT

World Health Organization website. Retrieved from


Countries around the world take different approaches to addressing health and health care for their citizens. While developing countries have much different needs than industrialized countries, comparing nations that fall into like categories can provide valuable insight into how to improve health care for a populace. Policy analysts at the Commonwealth Fund found that the United States did not perform well compared to similar countries as reported in their study, Mirror, Mirror 2017: International Comparison Reflects Flaws and Opportunities for Better U.S. Health Care. Five domains were examined in their study: care process, access, administrative efficiency, equity, and health care outcomes.

Case Assignment

After reviewing the background materials and conducting your own research, examine each of these domains. Discuss what they are and how the United States performed. Provide an analysis of what can be learned from other countries to improve the United States’ performance. Be sure that you are citing more than just the Commonwealth Fund report in supporting your analysis.

Assignment Expectations

  1. Conduct additional research to gather sufficient information to justify/support your analysis.
  2. Limit your response to a maximum of 5 pages.
  3. Support your paper with a minimum of 3 reliable sources.
  4. Please use the following resource for evaluating information found on the internet:
  5. You may use the following source to assist in your formatting your assignment:

Health Economics, Policy and Law (2012), 7: 11–13
& Cambridge University Press 2012 doi:10.1017/S1744133111000259


The role of comparative health studies for
policy learning


Professor of Health Policy and Management, Department of Health Policy and Management, Emory University,

Atlanta, USA

Comparative studies serve as a valuable but idiosyncratic mirror that can be
held up to a particular country’s health system. Valuable in that they reflect back
what is happening elsewhere. Idiosyncratic in that the reflection is distorted by
differences of national context and culture embedded in existing organizational
and institutional arrangements, masquerading as structural fact.

This essential tension between reflection and distortion – between useful as
against less useful information, between transferrable as against less transfer-
rable strategies and approaches – sits at the heart of the comparative enterprise.
The interesting question, as always, is what information is reflection, and what
is distortion and who decides. A further question is whether and/or how this
balance differs among different countries, and/or shifts over time.

Comparative studies make it possible to identify strategies and/or activities
that are similar across a group of countries. For example, over the last 10 years
or so, there has been an increasing trend among Western European countries to
reverse previous forms of decentralized administration in favor of strengthening
state control – even when that state control is used to re-structure health care
institutions on a more independent market-oriented manner (e.g. Norway).
More centralized state control over funding can be seen in countries like Denmark,
Germany, Netherlands, and, to a lesser degree, in countries still committed to
decentralization such as Italy and Sweden. More centralized control over provider
institutions, particularly hospitals, can be found in Norway, Denmark, Ireland and
(to a lesser degree) Estonia. This trend toward re-centralization is not universal –
few trends are. Certainly the new government in the United Kingdom is moving
in a different direction, and countries like Spain and Finland remain highly
decentralized in policy as well as practice. However, it is worth noting that some
policymakers in both the latter two governments are struggling to find ways to

*Correspondence to: Professor Richard B. Saltman, Professor of Health Policy and Management,

Department of Health Policy and Management, Rollins School of Public Health, Emory University, 1518

Clifton Road NE, Atlanta, GA 30322, USA. Email: [email protected]


re-centralize that might be compatible with the existing nation


Leiyu Shi


One North Franklin Street, Suite 1700
Chicago, Illinois 60606-3529
Phone: (301) 362-6905, Fax: (240) 396-5907
Order No.: 2238

ealthcare policies continue to evolve and subsequently must be integrated into
healthcare system operations. This book introduces readers to health policymaking,

critical health polic y issues, health polic y research and evaluation methods, and
international perspectives on health policy. Leiyu Shi takes a unique perspective by
integrating all these topics into this one-of-a-kind book. Real-world cases and examples
reinforce the theories and concepts throughout the book and address all healthcare settings,
including public health, managed care, ambulatory care, extended care, and hospitals.

Introduction to Health Policy provides an overview of:

✦✦ Health determinants and health policy formulation

✦✦ Major types of health policies, including those affecting special populations, such
as racial and ethnic minorities, low-income individuals, senior citizens, women and
children, people with HIV/AIDS, people with mental illness, and the homeless

✦✦ Health policy issues related to financing and delivery of healthcare in the
United States and abroad

✦✦ The importance of an international perspective from both developed and
developing countries

✦✦ Processes and context for federal, state, and local health policymaking

✦✦ Health policy research methods for use in studying and analyzing policy issues

Leiyu Shi, DrPH, is professor of health policy and health services research at the Johns Hopkins University Bloomberg School
of Public Health in the Department of Health Policy and Management. He also serves as director of the Johns Hopkins Primary
Care Policy Center. He received his doctoral degree from the University of California, Berkeley, majoring in health policy and
services research. He has conducted extensive studies on the association between primary care and health outcomes, in particular
the role of primary care in mediating the adverse impact of income inequality on health outcomes. Dr. Shi is also well known
for his extensive research on vulnerable populations in the United States. He is the author of nine textbooks and more than 150
scientific journal articles.

“Dr. Shi’s book introduces readers to the opportunities and issues of policymaking in
both US and international contexts. His knack for illustrating complex theory with

challenging and relevant real-life examples makes this field really come to life.”
—Gregory D. Stevens, assistant professor of family medicine and preventive medicine,

Keck School of Medicine, Universit y of Southern California