Setting health priorities across nations: more convergence than divergence?

Recently, various theories of convergence of health care systems have been presented. This review of several dimensions of health priority setting in nine countries sheds light on the interrelationship between convergence and embeddedness. It reconfirms that within a co-existence of convergence and divergence, there are clusters of convergence, primarily at the ideational and social value levels. However, our findings suggest that the variation across different substantive levels is less clear cut than suggested by others. Moreover, the variation between different procedural aspects of convergence appears more significant. Certain ideas involving the need for rationing, the role of market mechanisms, and cost containment have gained recognition by health policy makers across countries, but this has not guaranteed their adoption. Our analysis demonstrates that despite these signs of a convergence at the conceptual level, policy content and the preferred policy instruments for implementing such policy continue to vary widely across these countries.