Health care reform: No revolutio...( BLOOMINGTON Ind. -- A new study invo...),Health

BLOOMINGTON, Ind. -- A new study involving health care systems in 21 countries -- and the prospects for change in response to such common pressures as rising costs and aging populations -- casts doubt on the possibility of major overhauls of any of these systems because of the history and traditions that created them.

The findings, published on Friday in the online issue of the Journal of Health and Social Behavior, comes as the election of President-elect Barack Obama and his cabinet choices concerning health have increased speculation of substantial changes ahead for the unwieldy U.S. health care system.

"Our findings explain, to the dismay of many who would like to see more radical change in the U.S., why President-elect Obama's campaign proposal regarding health care reform was pretty much a center proposal, compared to Sen. McCain's to the right," said Indiana University sociologist Bernice Pescosolido. "Why didn't Obama's go farther toward considering a state model? In normal times, societies can only tolerate systems that match their understanding of what a health care system should look like. It showed an understanding of the tolerance for change."

The study, by an international team of medical and political sociologists including Pescosolido, found that the health care systems in the 21 countries varied in form according to government involvement and expenditure. They shared similar pressures for change, but any change likely would be incremental and unique to that country and its people. Thus, it is unlikely that wholesale change would occur or that health care systems around the world will eventually evolve to reflect one common approach.

"People are socialized into a contract that is essentially established between the state and the citizens of this country, and they come to believe that this is the best way to do it," Pescosolido said. "Even though there are similar pressures on health care systems aro
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