Health care reforms around the world--from Europe and North America to Africa, Latin America and Asia--seem to all be market-oriented reforms driven by international business interests and right wing political parties. There seems to be a sudden and broad concern with the "efficiency" of medical care, with the assertion that democratically or professionally run systems are inherently inefficient. Far less concern is evident for the more traditional values held regarding medical care, "effectiveness" (or quality) and "equity." The fact is that we have little good cross-national research...

After World War II, Sweden led the Western world in social programs. By the 1970s it was considered a model of the successful welfare state, providing a broader and more elaborate system of social programs and security to more people than any other country, the centerpiece of which was its health care system. As Twaddle explains, however, by 1990 there was a significant shift in Sweden's health policy debates.

Instead of speaking about the medical care system in terms of effectiveness, solidarity, and public planning, the discussions grew focused on competition, markets, and...