Macro-Comparative Political Analysis: Do Different Healthcare Systems Result in Differential National Health Outcomes?

Abstract

In this study, I will conduct a comparative analysis of how the the political-economic set-up of health care systems in affluent capitalist democracies may affect aggregate health care performance in designated OECD nations impact healthcare outcomes. The research question that will be answered is, “How does national design of health care institutions and development influence comparative quality of healthcare systems?” I will be looking closely at this macro- level relationship by identifying economic indicators and institutional rules that govern rational behaviors and that structure the interaction between individual actors, where there are principals who ultimately demand the health services and their outcomes—above all service recipients, but also their employers and the governments whose politicians try to deliver outcomes that will make voters reelect them. Agents are put in charge of the actual implementation of health services and thereby have superior knowledge of the operational steps it takes to deliver the requisite health care to restore sick patients, and principals (government and doctor) which influence patient care outcomes. A healthcare system is defined as an arrangement in which different category of actors combine in a system of institutionalized rules to deliver health services and thereby influence the physical and psychic health and satisfaction of customers with the system employing different patterns of resource expenditure (Ludwig, Van Merode, and Groot 2010). One evaluative measure of the efficacy of these components is to analyze the health service outcomes, the actual health of the citizens who are benefactors of the system. The main hypothesis explored in the thesis is that the design of health care systems, documented in institutional rules governing the interaction between the various actor groups, shapes the actual health outcomes.