In many countries around the world, the goal of healthcare reform is to improve quality, accessibility and affordability. A broader goal, shared across nations and demographic groups, is to create healthy populations that are well informed about their health, and that can make the best choices about their care.

As with any major policy effort, there are a lot of moving parts and it is important to keep in mind that any change, even small ones, can have large ripple effects throughout the system. A simple example is the way that hospitals are impacted when patients aren’t able to pay for their bills. When this happens, it can push up costs and prices for all other payers in the system.

A key piece of the Obama administration’s healthcare reform efforts is to bring greater accountability to the system by laying out common sense rules that will keep premiums down and prevent insurance industry abuses like denials or charging more for pre-existing conditions. Another key project is to change the way medical practitioners are paid. Instead of the current fee for service model, which encourages doctors to perform procedures that generate income, the projects aim to tie payments to outcomes. This would give doctors more incentives to focus on the things that really matter – delivering a high level of care to their patients.

One final point is that any healthcare reform process must ensure that measurable improvements are made and that the benefits of those improvements are sustained over time. Linear cause-and-effect logic (let us do reform X to realize benefit Y) doesn’t always hold in healthcare systems, but well-designed evaluations can help to ensure that progress is both real and sustainable.