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Abstract
Conflicting political calculations, economic implications, and ethical concerns have led to a confused national debate regarding health system reforms: How should we deal with doctors{u2019} demands for more money? What strategies exist to reduce costs for medical care while expanding social insurance to cover the poor? Should we expand the system of publicly provided health centers, or move more to private practice family physicians? Should we ask patients to pay more out of pocket, or make more use of general tax revenues? Is the answer more new technology or less? More doctors or fewer medical schools? Building new hospitals or spending more on anti- smoking campaigns? Current economic, political, social, and epidemiological complexity requires, as never before, formal analyses of health policy options for developing a health system that has the ability to anticipate problems and not just react to crises