Health services researchers around the globe have known for decades
that the United States, with a comparatively young population, spends much
more on health care than do other nations1,2 (Table 1). As US annual health spending
continues to exceed that in comparable nations by ever wider margins, and
as US health policymakers begin to run out of ideas for how to constrain that
growth, interest in the performance of health systems abroad has increased
in recent years. One need not import another country's political system or
social ethic to learn from the techniques they use to seek cost-effective
health care. Cost-effective health care delivers the maximum attainable benefit
for a given sacrifice of resources or, alternatively viewed, minimizes the
sacrifice in resources for a given level of benefits. While economic circumstance
and a preferred social ethic may lead some nations to spend more on health
care to achieve higher levels of benefits than others, in principle, all nations
should strive for cost-effective health care at whatever level of health spending
they have chosen.
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