Health care systems around the world struggle to reconcile three competing objectives: equitable access, high quality, and low cost. The trade-offs among these goals are inherently political. Should governments, for example, ration capacity in order to lower costs, even if doing so creates longer waiting times for care? Should they provide coverage to all citizens? Mandate quality standards?

As political and local as such choices may seem, many of the challenges reformers face are common to almost every health care system: for instance, increased supply creates additional demand for care and often fails to generate commensurately better outcomes, such as longer life expectancy. In many countries, higher spending does not correlate with higher-quality health care as perceived by consumers.

A comprehensive approach

The universal features of health care systems across the developed world suggest that today’s reformers, who tend to be piecemeal in their interventions, would benefit from a more holistic approach: one that recognizes the strong interdependency of seemingly autonomous actions. Reformers need a comprehensive perspective lest their remedies for one aspect of a health care system generate unintended—and potentially negative and costly—implications for another part.

Developing a comprehensive perspective for such a complex challenge requires a framework to...