The course first of all provides a critical analysis of market failures in the health care sector and describes in what spheres government action is required. The seriousness and empirical relevance of market failures and the capacity of government action to correct them will be ascertained by referring to both international and Swiss experience. The course then explores the tensions associated with the desires to increase access to care, improve quality, and limit rising costs. It examines alternative approaches to structuring a nation´s health system, the tensions between federalism and universal access, it develops an analytic framework for the comparative analyses of health systems and for the evaluation of reform proposals. Finally, the course will also focus on the challenges of health systems in developing countries where economic and human resources as well as the quality of political institutions are limited.