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Purpose -- The purpose of this paper is to present the three critical changes needed to reform the US health care system -- these changes will drive cascades of other beneficial changes. These three changes include the use of transparent market prices, alignment of incentives and systematic assessment and ratings of quality. Design/methodology/approach -- The paper used an analysis based on the literature on the comparison between non-market and market systems. The current US health care system is similar to the Soviet economic system, and the paper proposes moving it gradually to where it can respond to market-based signals. Findings -- The US health care system needs to adopt transparent and real pricing, independent quality assessment of health provider organizations and portable electronic patient records. These changes will lead to continuing cascades of innovation and improvement. Research limitations/implications -- The recommended changes will be opposed by vested interest groups, and so will be easier with regulatory guidance and encouragement. It would also be useful to protect against "regulatory capture" by interested parties during the change process. Practical implications -- Health care in the USA will gradually become better and cheaper. Health organizations will become more transparent. Regulators would have to set up and supervise private quality ratings agencies. Social implications -- Social implications of this paper include greater labor mobility and higher productivity, as well as increased competitiveness of the USA. Originality/value -- In spite of numerous writings on the subject, this issue has not been analyzed in this way. This paper is unique in the way in which it layouts the process of movement to a market-based system for the US health care system. [ABSTRACT FROM AUTHOR]

Purpose -- The purpose of this paper is to reflect on some policy possibilities and outcomes for three countries of interest suggested in Porter's The Competitive Advantage of Nations. Design/methodology/approach -- This research was both exploratory and qualitative in nature and utilized an in-depth case study approach of three major international economies reflecting previous observations in The Competitive Advantage of Nations. Personal contemporaneous observations of individuals in the countries of interest were complemented by current secondary information. The three countries selected for analysis, South Korea, Sweden and the USA, reflected different stages of development at the time The Competitive Advantage of Nations was published and certainly different progress since then. Findings -- The Competitive Advantage of Nations advocated new, constructive and actionable roles for government and business. These observations can now be tested after a reasonable time of development. In terms of development, Korea would appear to be the star of the group; Sweden has made strong progress in comparison with other members of the European Union. Although there are areas of strength, the USA recently has lost much of the edge it had at the time of the Advantage's publication. Research limitations/implications -- Because this research was built on case studies, one has the reservations common with that approach. On the other hand, case studies are acknowledged as useful in the identification of important variables in situations in which there is little control over events in a real-world context. Practical implications -- Countries must go their own way and find their own paths to success. In some ways, directions are suggested by Schumpeter (1942/1975) and in others, by Porter (1990/1996). Chance appears to have played a role in development in each instance, but government, seen as a fifth determinant possibility by Porter, heavily affected outcomes in each instance. Originality/value -- Although relying heavily on Porter, results add insight into the development of economies over time. [ABSTRACT FROM AUTHOR]