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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).