Theory and Method for the Cross-National Study of Health Systems

Abstract

The comparison of nations' health systems requires some way of categorizing them. As distinct from the typologies of Roemer, Maxwell, and others, which offer no apparent theoretical derivation, the schema suggested here derives from theory of the capitalist political economic world-system as put forth by Wallerstein and others. With the worldwide division of labor entailed in this perspective (core, semi-periphery, and periphery), combined with the strengths of workers' movements, five types of nations' health systems are identified, and illustrative comparisons are made using the contrasting case studies method. The author also discusses seeming exceptions to the general rule of capitalist dependencies with weak workers' movements having inequitous inadequate health systems.