Trends in time: Identifying health care system introductions worldwide

The present research aims to identify the timing of health care system introductions in countries across the globe, an event which represents the state’s assumption of substantial responsibility in the health (care) of its people. In doing so, we especially look for trends in time, which refers to the clustering of system introductions over a distinct period, whether marked by shared historical experiences or by simple virtue of their proximity in years. Our study is structured as follows: First, we set out to identify the introduction date of each country’s system starting in 1883 with the creation of the first health care system in the world. We then proceed to map out introduction dates for the entire period of observation and all countries to explore whether trends emerge. Looking beyond domestic factors that are traditionally associated with the development of social policies, we explore the potential impact of transnational events as drivers of social policy change, such as de-colonization, membership in international organizations, and the introduction of a health care system in a neighboring country. While the present paper does not tease out the explanatory factors contributing to the rise of health care systems worldwide, by identifying trends in their timing, our study provides important clues as to the potential influences of transnational interdependencies in driving social policy, as well as points to future avenues for comparative research.