This special double issue of the Journal of Health Politics, Policy and Law is a collection of papers presented at meetings held by the European Health Care Systems Discussion group--a forum for health system scholars from throughout Europe who meet regularly to discuss intra- and intercountry analyses of health care system reform. Reaching beyond simple descriptive reporting on the health care system of their particular country, contributors from across Europe develop a much deeper understanding of health sector reforms by placing emphasis on how the health care system of their country promotes--and has been reformed to promote--efficiency, equity, accountability and responsiveness within the specific political, historical, and cultural contexts of their countries (including Denmark, England, Finland, France, Germany, Greece, Italy, the Netherlands, Portugal, Spain, and Sweden).