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Abstract

International reforms of health care systems over the last decade have addressed three fundamental issues: coverage, cost, and control. The general approach has been to move the health care systems toward the use of markets or quasi markets and to decentralize as much as political and social structures will allow. In this paper I assess the three issues raised above (referred to here as the three c's) and provide examples of different reform proposals in the United States, the United Kingdom, and the Czech Republic. I conclude with some thoughts on where the reforms are headed in the twenty-first century.

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