The key issues of the health care system are often conceptualised as involving three basic dimensions: the quality of health care provided; access to the health care system and the cost of health care. This book presents studies of two distinct types of reform that have been implemented to reduce the 'trade offs' arising from the 'unholy trinity'. The first focuses upon attempts to reorganise existing institutions in order to make them more effective and cost-efficient. The second considers the move toward 'evaluation research', that is, more critically evaluating health care treatments and outcomes to make sure that treatments are effective and cost-efficient.