Authors:

Abstract

In broad terms, the US health care system can be viewed as one that has increased the use of market forces in the 1980s. This last decade produced rapid and dramatic shifts in the organization and financing of health care. These changes followed a decade or more of intense government regulation and various attempts to use local health planning to direct resources, control health care expenditures, and provide an equitably acceptable distribution of medical services.

The shift to more competition in health care is best viewed as part of an overall philosophical change in the US to less government regulation and more reliance on the private sector. Although the pattern was not consistent in this regard, political forces led to the deregulation of the airline industry, the lifting of some federal regulations in the banking industry, and the placing of stricter limitations on price supports in agriculture. This climate of deregulation along with a rapidly expanding health care sector led to the increasing reliance on market forces to allocate health care resources.

The first chapter reviews the major changes in the 1980s that have led to more reliance on the market for health care in the US. We focus on the major regulatory changes, lifting of legal barriers on market forces, and changes in organization and financing of health care. The paper points out some lessons that the United Kingdom could learn from the US experience with a more competitive health system which may be useful if the British government's White Paper reforms are implemented as planned.

Full Article [PDF]

[Back To Top]