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Universal principles for health care reform Health care systems in developed countries are notoriously resistant to reform, in large part because of their competing objectives: access, quality, and cost.Policy makers and health ministers tend to approach reform in a piecemeal fashion that underestimates the strong interdependency among seemingly autonomous actions.To create a cohesive overview of the complicated relationship among the competing goals common to all health systems, the authors looked for (and unbundled) the primary elements of supply and demand in the health care systems of developed countries. In so doing, they formulated principles that apply across a broad spectrum of health systems.This framework shows that local differences in health care systems need not preclude a structured, systematic approach to reform based on enduring, universal principles.  
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