This special double issue of the Journal of Health Politics, Policy and Law is a collection of papers presented at meetings held by the European Health Care Systems Discussion group--a forum for health system scholars from throughout Europe who meet regularly to discuss intra- and intercountry analyses of health care system reform. Reaching beyond simple descriptive reporting on the health care system of their particular country, contributors from across Europe develop a much deeper understanding of health sector reforms by placing emphasis on how the health care system of their country promotes--and has been reformed to promote--efficiency, equity, accountability and responsiveness within the specific political, historical, and cultural contexts of their countries (including Denmark, England, Finland, France, Germany, Greece, Italy, the Netherlands, Portugal, Spain, and Sweden).

Recognized scholars from 15 countries offer rich political analyses of 71 European leaders chosen for the significant roles that they have played nationally, regionally, or internationally since 1945. Each in-depth political and intellectual biography assesses the leader's achievements and failures in historical context, key career moments, major allies and opponents and their impact, and the leader's interplay with different political institutions. The profiles cover representative types of political leaders across the political spectrum from left to right, heads of state and chiefs of government, and political figures that have been important in European history over the last 50 years. Leaders describe important political moments in Austria, Belgium, Denmark, France, Germany, Greece, Ireland, Italy, the Netherlands, Norway, Portugal, Spain, Sweden, and the United Kingdom. The essays arranged alphabetically also give a few primary and secondary sources for further research. A short chronology and bibliographical essay on the subject of European political leadership and a full index further enhance this major reference designed for undergraduates and graduate students and for scholars, government officials, and journalists in political affairs, European studies, world history, and international relations.

All advanced health care systems face severe difficulties in financing the delivery of today's sophisticated medical care. In this study David Wilsford compares the health systems in France and the United States to demonstrate that some political systems are considerably more effective at controlling the cost of care than others. He argues that two variables--the autonomy of the state and the strength and cohesiveness of organized medicine--explain this variance.
In France, Wilsford shows, the state is strong in the health policy domain, while organized medicine is weak and divided. Consequently, physicians exercise little influence over health care policymaking. By contrast, in the United States the state is weak, the employers and insurers who pay for health care are fragmented, and organized medicine is strong and well financed. As a result, medical professionals are able to exert a greater influence on policymaking, thus making cost control more difficult.
Wilsford extends his comparison to health care systems in the United Kingdom, West Germany, Italy, Canada, and Japan. Whether the private or public sector finances health care, he discovers, there is now an important trend in all of the advanced industrial countries toward controlling escalating costs by curbing both the medical profession's clinical autonomy and physicians' incomes.