ALTENSTETTER, Christa. Insights from health care in Germany. American Journal of Public Health, Washington, v. 93, n. 1, p. 38-44, Jan. 2003.

German Statutory Health Insurance (national health insurance) has remained relatively intact over the past century, even in the face of governmental change and recent reforms. The overall story of German national health insurance is one of political compromise and successful implementation of communitarian values. Several key lessons from the German experience can be applied to the American health care system.

BROWN, Lawrence D. Comparing health systems in four countries: lessons for the United States. American Journal of Public Health, Washington, v. 93, n. 1, p. 52-6, Jan. 2003.

The rekindling reforms initiative examined the health systems of 4 countries: Canada, France, Germany and Great Britain (United Kingdom). From the 4 country reports published in this issue of the American Journal of Public Health, 10 crosscutting themes emerge: (1) coverage, (2) funding, (3) costs, (4) providers, (5) integration, (6) markets, (7) analysis, (8) supply, (9) satisfaction, and (10) leadership. Lessons for the United States are presented under each point.

LIGHT, Donald W. Universal health care: lessons from the British experience. American Journal of Public Health, Washington, v. 93, n. 1, p. 25-30, Jan. 2003.

Britain’s National Health Service (NHS) was established in the wake of World War II amid a broad consensus that health care should be made available to all. Yet the British only barely succeeded in overcoming professional opposition to form the NHS out of the prewar mixture of limited national insurance schemes, charity care, and public health services. Success stemmed from extraordinary leadership, a parliamentary system of government that gives the winning party great control, and a willingness to make major concessions to key stakeholders. As one of the basic models emulated worldwide, the NHS – in both its original form and its current restructuring – offers a number of relevant lessons for health reform in the United States.

RODWIN, Victor G. The health care system under French National Health Insurance: lessons for health reform in the United States. American Journal of Public Health, Washington, v. 93, n. 1, p. 31-7, Jan. 2003.

The French health system combines universal coverage with a public-private mix of hospital and ambulatory care and a higher volume of service provision than in the United States. Although the system is far from perfect, its indicators of health status and consumer satisfaction are high; its expenditures, as a share of gross domestic product, are far lower than in the United States; and patients have an extraordinary degree of choice among providers. Lessons for the United States include the importance of government’s role in providing a statutory framework for universal health insurance; recognition that piecemeal reform can broaden a partial program (like Medicare) to cover, eventually, the entire population; and understanding that universal coverage can be achieved without excluding private insurers from the supplementary insurance market.