Healthcare policies over the last 20 years: reforms and counter-reforms.

The case argued in this article is that the last two decades have been characterised by distinct waves of healthcare reforms. The first, in the early 1990s, aimed to introduce more patients' choice and greater competition between the components of the healthcare system. The second, from 1995 to 2000, had the opposite aim of introducing greater integration and regulation. From 2000 onwards, the policy issue more in vogue has been the strengthening of patients' rights. Looking for the motives behind these reform strategies, this article aims to show how the ideological leaning of the governments in power affects the content of reform initiatives. The analysis presents evidence drawn from six OECD countries: France, Germany, the Netherlands, New Zealand, Sweden and UK. Copyright 2009 Elsevier Ireland Ltd. All rights reserved.