Political challenges for healthcare reform

Bright ideas for health reform abound in Western nations, but moving proposals into policy requires surmounting political challenges. This paper briefly reviews three central challenges: installing reforms not merely "on the public agenda," but also high on the agendas of public and private stakeholders; designing for the reformed system a division of labour acceptable to key actors and institutions; and finding a reform model that is both substantively plausible and politically appealing. Successful hurdling of these challenges is easier said than done.