Comparative Health Administration

Paul G. Thomas is a political science professor at University of
Manitoba and co-author of Canadian Public Administration: Problematical
Perspectives.

This collection consists of 19 articles by social scientists and policy
analysts dealing with health-care policy and administration issues in
both developed and developing countries. It is clearly intended for a
very specialized audience. Among the countries studied are Australia,
Canada, Chile, China, Hong Kong, Nigeria, the United Kingdom, and the
United States. The editor of the volume offers overview articles for
Section 1, which deals with developed countries, and Section 2, which
look at health issues in developing countries.

Two articles examine Canadian developments. Robert G. Evans, this
country’s leading health economist, argues that public health
insurance is deliberately redistributed and involves the collective
purchase of care, which has meant lower-cost and better coverage than is
found in the United States. A second article contrasts the more
interventionist role of the Quebec government in the management of the
health system with that of the Ontario government.

The chapters dealing with developing countries examine the health
impacts of such forces as the population explosion, uneven distribution
of services, a lack of appropriate technology, and a lack of financial
and professional resources. Other articles examine the state of primary
health care in different national settings and the impacts on
health-service provision of different remuneration systems for
physicians.

Taken as a whole, the volume indicates the close connection between a
country’s health-care system and the characteristics and values of its
society, economy, and political system. It should be noted that most of
the articles date from the late 1980s; in the dynamic field of health,
much has changed since then.