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Abstract

Treforms of the National Health Service (NHS) are important to the citizens of the United Kingdom (UK), but they also represent a significant change in health care policy that will influence a large number of other countries that are in the process of deciding on their own reforms or implementing them. For many years the NHS has been held up as the standard of an equitable and cost-effective system. It has been used by many countries as a "model" of what a health system should desire to achieve.

This glowing report of NHS is a bit overstated, given the well-known queues for hospital procedures and the lack of productivity in some areas of physician practice (x-3). However, it does have many features that are very attractive: universal coverage, a sense of equity, litde interference in the practice of medicine, and a global budget system that keeps aggregate costs under control. Perhaps even more attractive is the trust and support that the NHS has earned for more than 40 years from a large majority of the population and the providers. Indeed, the NHS is a cherished institution in the UK.

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