Introduction

Abstract

Comprehensive publicly funded health care delivery systems were centrepieces of postwar welfare state programs. In the closing decades of the twentieth century, these systems were plagued by escalating costs and stretched by a burgeoning demand for services. The pressures reflected such factors as rising labour costs, aging populations, increased service intensity across all age groups, soaring drug costs, and expensive technological breakthroughs in diagnostic and treatment procedures. The four countries that are the focus of this book – Britain, Australia, New Zealand and Canada – saw total expenditures on health care rise between 1980 and 2000. According to the Organization for Economic Cooperation and Development (OECD), the four-country average climbed from 6.4 percent of GDP to 8.2 percent.