“Comprehensive Healthcare for America” is a largely single-payer reform proposal that, by applying the insights of behavioral economics, may be able to rally patients and clinicians sufficiently to overcome the opposition of politicians and vested interests to providing all Americans with less complicated and less costly access to needed healthcare.

Established theories of social policy development, such as industrialisation and power resources, have been extensively used to explain the expansion of social policy, predominantly in developed economies. We argue that they may not always be applicable in the Global South. Our article examines multiple factors at play in Indonesia’s healthcare policy expansion using qualitative content analysis of historical sources, literature, and nine interviews with key policy architects. Using the pull-and-push factor model, we examined the interactions between policy entrepreneurs and centre-right political parties in creating national healthcare policy architecture and expansion. Our findings confirm that the window of opportunity for expansion was augmented when the political party of the ruling government experienced a decline in public trust, while clientelistic motives among elites facilitated the reform process. Drawing the lesson from Indonesia, we contend push prevails over the pull factors (labour movement and cross-class alliances) in social policy development.

This article provides an overview of the scholarship on healthcare reform in democratic middle-income countries through comparative cases from Indonesia and Thailand. This study identifies the reasons why Thailand has achieved universal healthcare faster than Indonesia and analyses the policy outputs towards universalism resulting from unfolding reforms. Taking a closer look at the causal mechanisms underpinning healthcare developments (clientelistic-based mechanism and limited vertical alliance-based mechanism), we discuss how changes in political economy have enhanced the state’s intervention in the healthcare sector while reproducing the fragmented and stratified nature of the system. Based on coverage, generosity and financial risk protection, Thailand has a higher degree of universalism in comparison with Indonesia. The article suggests that the welfare regime now governing healthcare can be conceptualised as a developmental-universalist state, while noting a less-effective model for Indonesia and a more effective model for Thailand.

The reform approved in Peru in 2009 during a right-wing government deviates from similar attempts in the region to expand access to healthcare. Left-wing parties in Peru were extremely weak during the policy-making process and the political parties were non-programmatic. Based on original field research, this article demonstrates how parties that lacked core values uniting their leaders and had no commitment to the health reform did not care for the definition of specifications regarding funding and implementation. Instead, technocrats dominated the process of policy formation, which, accompanied by the lack of commitment from key political actors, led to poorly specified policy and deficient implementation.

For countries faced with much talk but little action on healthcare reform, China’s National Health Guiding Principles (CNHGP), with its 60-year history, may provide a new perspective. There are four values of CNHGP for healthcare reform. First, these principles provide an innovative strategic framework for healthcare reform with three levels, from ‘One priority population’ to ‘Four approaches’ and then to ‘Two aims.’ The second is the importance of mass/grassroots participation, which runs through all three levels of CNHGP. The third value is that the CNHGP used nonspecific social approaches, an innovation in healthcare delivery that addressed the social determinants of health. The fourth value is the integration between Chinese traditional medicine and Western medicine.

Background: In the debate on improving the quality and efficiency of the United States healthcare system, comparative effectiveness research is increasingly seen as a tool for reducing costs without compromising outcomes. Furthermore, the recent American Recovery and Reinvestment Act explicitly describes a prioritization function for establishing a comparative effectiveness research agenda. However, how such a function, in terms of methods and process, would go about identifying the most important priorities warranting further research has received little attention.

Objectives: This study describes an Agency for Healthcare Research and Quality-funded pilot project to translate one current comparative effectiveness review into a prioritized list of evidence gaps and research questions reflecting the views of the healthcare decision makers involved in the pilot.

Methods: To create a prioritized research agenda, we developed an interactive nominal group process that relied on a multistakeholder workgroup scoring a list of research questions on the management of coronary artery disease.

Results: According to the group, the areas of greatest uncertainty regarding the management of coronary artery disease are the comparative effectiveness of medical therapy versus percutaneous coronary interventions versus coronary artery bypass grafting for different patient subgroups; the impact of diagnostic testing; and the most effective method of developing performance measures for providers.

Conclusions: By applying our nominal group process, we were able to create a list of research priorities for healthcare decision makers. Future research should focus on refining this process because determining research priorities is essential to the success of developing an infrastructure for comparative effectiveness research.

Objectives: The Turkish healthcare system is currently undergoing reform, and efficient use of resources has become a key factor in determining the allocation of resources. The objective of this study was to analyze strengths, weaknesses, opportunities, and threats (SWOT) in the development of a health technology assessment (HTA) program in Turkey.

Methods: A SWOT analysis was performed using a literature review and interviews with key people in the Turkish Ministry of Health and Ministry of Labor and Social Security.

Results: Regarding recent reforms in health care, investments for information network and databank are the strengths, but the traditional “expert-based” decision making, poor availability of data, and poor quality of data could be seen as some of the weaknesses. Another major weakness is lack of general awareness of HTA. Increasing demand for transparency in decision making, demand for evidence, and demand for credibility by decision makers are some of the opportunities, and current healthcare reforms, i.e., restructuring of healthcare and general health insurance, could also be seen as major opportunities. These opportunities unfortunately could be threatened by lack of funding, and resources are challenged by large, recent national investments.

Conclusions: There is a good opportunity for Turkey to use the skills in HTA currently being developed through activities in Europe and the Americas to assist in the development of a much more cost-effective and transparent healthcare system in Turkey.