Risks and benefits of comparative studies: notes from another shore

The fascination of American and British scholars with each other's health care systems is a case study of the risks and benefits of the comparative approach. The risks stem from the temptation to seek solutions to national problems in the experience of other countries in a way that ignores the fact that whereas institutions may, in theory at least, be exportable, their social, political, and economic environment is not. The benefits derive from the fact that only a comparative approach can hope to identify the factors that are specific to national health care systems, as distinct from being common to all such systems. Finally, a comparative perspective can extend national ideas about what is possible and at the same time provide the understanding that must precede prescription.