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From the Editor

Foreign Lessons: Is There Value Added?

In this issue, we are also publishing the abstract of a paper that was released March 22 on the Health Affairs’ Web site. The paper, by Lynn Etheredge, outlines a proposed new variant of the tax credit concept. This paper represents a launch of our plan to publish papers that are especially time-sensitive on our Web site only, but to also alert readers to their availability by following up with an abstract in the next issue of the journal.

We open the issue with a paper by Robert Blendon and colleagues that compares how individual citizens in seventeen countries ranked their health care systems with the rankings of public health experts that the World Health Organization (WHO) compiled and published in a controversial report issued last year. The WHO report ranked the U.S. health care system thirty-seventh among all countries and last among industrialized countries. Christopher Murray and his WHO colleagues offer a critical response to Blendon in a perspective that immediately follows his paper. Next, Mark McClellan, who recently joined the Bush White House as one of the president’s chief health advisers, and Dan Kessler report on heart attack care in seventeen countries; and Linda Aiken and colleagues survey 43,000 nurses in some 700 hospitals in five countries. Following are three essays that discuss different dimensions of efforts to improve the quality of care here and abroad, two papers on pharmaceutical purchasing in Canada and Australia, two papers on primary care in Canada and the United Kingdom, and an interview with Australia’s health minister.

Once again, we are joined in this international effort by the Commonwealth Fund, a New York City–based private foundation. The Fund is directing substantial resources to building a broader network of policy-oriented researchers whose multinational experience and outlook encourage countries to reach beyond their borders for solutions to common problems. In 1996, under the directorship of Robin Osborn, the fund established the International Program in Health Policy as a successor to the Harkness Fellowships, an international exchange program it had operated since 1925. Its new Harkness Fellowships in Health Care Policy enable leading scholars from the United Kingdom, Australia, and New Zealand to conduct research in the United States that is relevant to health care policy in both the United States and the fellow’s home country.

While I generally devote this space to a brief discussion of the contents of the journal, I wanted to alert readers to an important new monograph that essentially challenges the Bush administration to undertake a thorough examination of the neglected links between U.S. foreign policy and health care. The recently published monograph, developed through a collaboration between the Council on Foreign Relations and the Milbank Memorial Fund, asserts: "The United States can gain significant domestic and international advantages by placing health squarely on its foreign policy agenda. Supporting public health worldwide will enhance U.S. national security, increase prosperity at home and abroad, and promote democracy in developing countries and those in transition." The full report is available online, <www.milbank.org>.

John K. Iglehart

Founding Editor

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