New Zealand's health system has many similarities with Canada, and also has longstanding experience with regionalization of healthcare services. Since 2001, the most important change has been the development of regional primary healthcare organizations funded according to population characteristics. This significant change has created the potential for a more integrated health system. However, barriers remain in realizing this potential. The key challenges include dealing with inter-organizational complexity and finding the right balance between hierarchical and collaborative relationships between the state and non-government providers. Although New Zealand governments have greater capacity to make changes to organizational and policy changes, professional interests retain considerable capacity to shape policy outcomes through implementation.
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