Learning from Other Countries: Comparing Experiences and Drawing Lessons for the United States

  • Mary Ruggie
Part of the Handbooks of Sociology and Social Research book series (HSSR)


Are there any medical sociologists who believe in the notion of American “exceptionalism” and resist considering US healthcare policy in comparative perspective? Alternatively, are there any who question whether comparisons of seemingly vastly different settings can yield fruitful lessons for the US? This paper seeks to convince the dubious in the worlds of both academia and healthcare policymaking that a comparative lens best illuminates the successes and failures of American health care and the unique framework within which it operates. We have much to learn from the experiences of other countries, not only about healthcare policy but also about the political and social parameters and the norms and values that shape it and its outcomes. Moreover, despite apparent differences, there are important similarities between our struggles and those of other countries. Understanding how and why their efforts have succeeded or failed can inform a more fruitful direction for American endeavors.


National Health Service Health Care Resource Healthcare Policy Sickness Fund Medicaid Program 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


  1. Allen D, Pilnick A (2006) The social organisation of healthcare work. Blackwell, LondonGoogle Scholar
  2. Ayres CG, Griffith HM (2007) Perceived barriers to and facilitators of the implementation of priority clinical preventive services guidelines. Am J Manag Care 13(3):150–155Google Scholar
  3. Budrys G (2003) Unequal health: how inequality contributes to health or illness. Roman and Littlefield Publishers, New YorkGoogle Scholar
  4. Burawoy M (2005) 2004 Presidential Address: For Public Sociology. Am J Soc 70(1):4–28Google Scholar
  5. Cutler DM (2004) Your money or your life. Oxford University Press, New YorkGoogle Scholar
  6. Davis K et al (2006) Mirror, mirror on the wall: an update on the quality of American Health Care through the patient’s lens. The Commonwealth Fund.
  7. Davis K et al (2007) Mirror, mirror on the wall: an international update on the comparative performance of American Health Care. The Commonwealth Fund.
  8. Gilbert N (2002) Transformation of the welfare state: the silent surrender of public responsibility. Oxford University Press, New YorkGoogle Scholar
  9. Grand JL (2006) Debate: choice and competition in the British National Health Service. Eurohealth 12(1):1–3Google Scholar
  10. Gray BH, O’Leary J (2000) The evolving relationship between medical sociology and health policy. In: Bird CE, Conrad P, Fremont AM (eds) The handbook of medical sociology. Prentice-Hall, New Jersey, pp 258–270Google Scholar
  11. Hacker JS (2004) Review article: dismantling the health care state? Political institutions, public policies and the comparative politics of health reform. Br J Polit Sci 34:693–724CrossRefGoogle Scholar
  12. Heritage J, Maynard DW (2006) Problems and prospects in the study of physician-patient interaction: 30 years of research. Annu Rev Sociol 32:351–374CrossRefGoogle Scholar
  13. Institute of Medicine (1990) Clinical practice guidelines: directions for a new program. National Academies Press, Washington, D.CGoogle Scholar
  14. Laditka JN, Laditka SB (2006) Race, ethnicity, and hospitalization for six chronic ambulatory care sensitive conditions in the US. Ethn Health 11(3):247–263CrossRefGoogle Scholar
  15. Light DW (2000) The medical profession and organizational change: from professional dominance to countervailing power. In: Bird CE, Conrad P, Fremont AM (eds) The handbook of medical sociology. Prentice-Hall, New Jersey, pp 201–216Google Scholar
  16. Marshall TH (1949) Citizenship and social class. In: Marshall TH (ed) Class, citizenship, and social development. Doubleday, New York, pp 65–123Google Scholar
  17. Mattke S et al (2006) Health care quality indicators project: initial indicators report. OECD health working papers, No. 22. OECD, ParisCrossRefGoogle Scholar
  18. McMahon LF Jr, Hofer TP, Hayward RA (2007) Physician-level P4P –DOA? Can quality-based payment be resuscitated? Am J Manag Care 13(5):233–236Google Scholar
  19. McWilliams JM et al (2007) Use of health services by previously uninsured Medicare Beneficiaries. N Engl J Med 357(2):143–153CrossRefGoogle Scholar
  20. Mechanic D (2004) The rise and fall of managed care. J Health Soc Behav 45:76–86Google Scholar
  21. Milgate K, Cheng SB (2006) Pay-for-performance: the MedPAC perspective. Health Aff 25(2):413–419CrossRefGoogle Scholar
  22. Mullahy J, Roberts S, Wolfe B (2004) Health, income, and inequality. In: Kathryn Neckerman (ed) Social inequality. Russell Sage, New York, pp 523–544Google Scholar
  23. Nagelkerk J, Reick K, Meenga L (2006) Perceived barriers and effective strategies to diabetes self-management. J Adv Nurs 54(2):151–158CrossRefGoogle Scholar
  24. O’Malley AS, Pham HH, Reschovsky JD (2007) Predictors of the growing influence of clinical practice guidelines. J Gen Intern Med 22:742–748CrossRefGoogle Scholar
  25. Oberlander J (2007) Health reform interrupted: The unraveling of the Oregon Health Plan. Health Aff 26(1):96–105CrossRefGoogle Scholar
  26. Pauly M (2006) The tax subsidy to employment-based health insurance and the distribution of well being. Law Contemp Probl 69:83–92Google Scholar
  27. Pear R (2007) A battle over expansion of children’s insurance. The New York Times. <>
  28. Pearson SD, Rawlins MD (2005) Quality, innovation, and value for money: NICE and the British health service. J Am Med Assoc 294(20):2618–2622CrossRefGoogle Scholar
  29. Pierson P (2000) Increasing returns, path dependence and the study of politics. Am Polit Sci Rev 94:251–67CrossRefGoogle Scholar
  30. Quadagno J, Street D (2006) Recent trends in US social welfare policy. Res Aging 28(3):303–316CrossRefGoogle Scholar
  31. Ranade W (ed) (1998) Markets and health care. Addison Wesley, LondonGoogle Scholar
  32. Rawlins MD (2004) NICE work – Providing guidance to the British National Health Service. N Engl J Med 351(14):1383–1385CrossRefGoogle Scholar
  33. Redmond P, Solomon J (2007) Can incentives for healthy behavior improve health and hold down Medicaid costs? Center on budget and policy priorities.
  34. Reschovsky JD, Hadley J, Landon BE (2006) Effects of compensation methods and physician group structure on physicians’ perceived incentives to alter services to patients. Health Serv Res 41(4):1200–1220Google Scholar
  35. Robinson JC (2001) Theory and practice in the design of physician payment incentives. Milbank Q 79(2):149–177CrossRefGoogle Scholar
  36. Rothman RL et al (2006) Labor characteristics and program costs of a successful diabetes disease management program. Am J Manag Care 12(5):277–283Google Scholar
  37. Ruggie M (1996) Realignments in the welfare state: health policy in the United States, Britain, and Canada. Columbia University Press, New YorkGoogle Scholar
  38. Saltman RB (2002) The Western European experience with health care reform.
  39. Schoen C, Doty MM (2004) Inequities in access to medical care in five countries: Findings from the 2001 Commonwealth fund international health policy survey. Health Policy 67:309–322CrossRefGoogle Scholar
  40. Selden T, Gray BM (2006) Tax subsidies for employment-related health insurance: Estimates for 2006. Health Aff 25(6):1568–1579CrossRefGoogle Scholar
  41. Sellers RM et al (2006) Racial identity matters: the relationship between racial discrimination and psychological functioning in African American adolescents. J Res Adolesc 16(2):187–216CrossRefGoogle Scholar
  42. Smedley BD, Stith AY, Nelson AR (2003) Unequal treatment: confronting racial and ethnic disparities in health care. National Academies Press, Washington, DCGoogle Scholar
  43. Starfield B, Shi L, Macinko J (2005) Contribution of primary care to health systems and health. Milbank Q 83(3):457–502CrossRefGoogle Scholar
  44. Toner R, Elder J (2007) Most support U.S. guarantee of health care. The New York Times.
  45. van Doorslaer E, Masseria C, Koolman X (2006) Inequalities in access to medical care by income in developed countries. Can Med Assoc J 174(2):177–183CrossRefGoogle Scholar
  46. Western Canada Wait List Project (2005) Moving forward: final report.
  47. Wynia MK et al (2003) Do physicians not offer useful services because of coverage restrictions? Health Affairs 22(4):190–197CrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC 2011

Authors and Affiliations

  1. 1.The John F. Kennedy School of GovernmentHarvard UniversityCambridgeUSA

Personalised recommendations