Journal on Policy and Complex Systems
either a small number of countries , they lack quantitative results that allow for consistent comparisons , or they focus on efficiency . Notable exceptions are the landmark 2018 GBD ( Study on quality of healthcare across 195 countries ( Anderson , Hussey , Frogner , & Waters , 2005 ; GBD 2016 Healthcare Access and Quality Collaborators , 2018 ), OECD ( 2017b ), and Mossialos et al ( 2016 ). Multiple articles by Siciliani and various confreres ( Hurst & Siciliani , 2003 ; Siciliani & Hurst , 2003 ; Siciliani & Verzullic , 2009 ; Siciliani , Moran , & Borowitz , 2013 & 2014 ) are also insightful , if restricted to OECD countries .
With the data available from these last sources , it is possible to draw a comparison between a number of countries to see how well they balance the various aspects of cheap , fast , and good ; however , the result would be more instructive if placed in the larger context . That context can be achieved through use of a computer-driven agent-based model , which will serve to illustrate various challenges in a general marketplace where both consumers and providers interact with each other . The Methods section of this paper will discuss the computer model , and the technique used to compare various countries health care systems . Following that will be the Results section , followed by Discussion , and Conclusion .
2 . Methods
The seminal work of Schelling
( 1969 ) with his social segregation model showed the power of agent-based models ( ABM ), while
Rochlin , Sarnea , and Zussman ( 2013 ) discussed the value of simple agentbased models in providing insight to a large number of issues . The " Sugarscape " model by Epstein and Axtell ( 1996 ) addressed economic issues . Beyond repeatability , one key factor these models bring is the ability to observe how an environment changes over time , as agents act on it , and in some cases how the agents themselves survive or perish . This enables us to see how businesses and consumers are able to remain in the market , or are forced to exit it because of maladaptation . This model was built using NetLogo 6.0.4 ( Wilensky 1999 ), and utilizes some of the inherent characteristics of NetLogo in driving interpretation of the model .
As can be noted in Figure 1 , there are two parts of the model : Setup , and Operation . During the Setup phase , the operator chooses the number of both types of agents — Providers , and Consumers . These agents are then configured , and prepared for the Operation phase . One option for the Setup phase is the inclusion of Balanced Providers . These are providers who have a balance between cheap , fast , and good ; where other providers are equally divided between Fast & Good , Cheap & Good , and Cheap & Fast . The Operation phase represents a single day , which then repeats . Each day , each consumer receives money and searchers for a provider .
The consumer compares providers based on whether or not the provider ’ s values for cheap , fast , and good meet or exceed its own . If they do ( and the consumer has sufficient money and
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