This book provides a framework for explaining why governments adopt the policies they do. In addition, it establishes a basis for comparing political systems in terms of their public policies rather than their institutions or political processes. The book begins by placing in a historical perspective the worldwide role of the state as a major provider of goods and services. Following this general background is an "accounting scheme" that brings some semblance of order to the seemingly infinite variety of policy-relevant variables and makes the comparative study of public policy more manageable. It is suggested that any nation"s public policies can be explained in terms of situational, structural, environmental and cultural factors. The second part of the book applies the accounting scheme to an increasingly specific and narrow range of public policies. The author examines one crucial area of public policy - health care - and the evolution of that policy in four diverse nations: Germany, Great Britain, the Soviet Union and Japan. The book concludes with an assessment of the prospects for an American national health care programme in the light of the experiences of these other nations.