The increase in health care expenditures is a major problem of all welfare states. To counter this trend, since the early 1980s, most OECD countries have changed the way hospitals are financed. Although these reforms are certainly linked to country-specific factors, the authors' main argument is that they are in part due to a diffusion process: Policy change in one country is influenced by previous changes in other countries. More specifically, the authors argue that policy makers learn from the experience of others. Using an original data set and event—history methods to test arguments, their results show that policy change is more likely when the existing policy is ineffective and when the experience of other countries suggests that the reform leads to the desired results. In addition, the authors find that the effects of learning grow over time and that early adopters tend to be countries with few veto players.

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Policy diffusion needs to be studied as a complex phenomenon, since it involves interdependent relationships between autonomous and heterogeneous countries. This chapter aims at developing a simple computational model based on a theoretical model of policy diffusion (Braun & Gilardi, 2006) that helps to explain the emergence of diffusion in a complex system. Based on three simple conditions (ready, choose, change) and a few internal and external characteristics that define countries and their interactions, the model presented in this chapter shows that policies do diffuse and lead to local convergence and global divergence. Moreover, it takes time for a country to introduce the best-suited policy and for this policy to become very effective. To conclude, diffusion is a complex phenomenon and its outcomes, as ensued from the author's model, are in line with the theoretical expectations and the empirical evidence.