European health systems reforms: looking backward to see forward?

In this article we outline the different schools of new institutionalism and a few other selected political science theories. Moreover, we relate the insights offered by a series of analyses of health sector change in a large number of European countries over the past twenty to thirty years to these theoretical frameworks. Our main conclusion is that it is unlikely that a single explanatory theory will ever be able to account for all of the health sector developments in any one country, let alone across many countries with diverse cultures, histories, institutions, and interest groups. Consequently, a real understanding of health sector change will require a recognition that different theoretical approaches will be more (or less) appropriate in some circumstances than in others.