Abstract
Healthcare has been the focus of wide-ranging reform efforts across the developed world for at least the last generation. Governments have sought to install market principles in the organization of healthcare, along with generic New Public Management. They have then worked to bring healthcare professionals back into leadership and pursued whole-of-sector collaborative approaches to organization, within a stronger hand of government. Meanwhile patient and population needs have increased in complexity and cost. This chapter describes different health systems, key challenges, and different policy approaches. It looks at examples in different countries, including present responses to building cross sector governance. The example of New Zealand is used to illustrate such responses but also as New Zealand has experimented widely with health care reform. The chapter notes broader lessons for public administration reform