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).