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BMJ 1995; 310 doi: https://doi.org/10.1136/bmj.310.6994.1558a (Published 17 June 1995) Cite this as: BMJ 1995;310:1558

“When I grew up in Glasgow health care was a right; carrying a machine gun was a privilege. In the USA it's the other way round.” This comment from Ian Morrison (Glaswegian, now president of the Institute for the Future, Menlo Park, California) during his BMJ lecture at BMA House a couple of weeks ago was to show that health care systems are determined by the culture of their country. In other words, despite the defects of the US health care system—which Ian Morrison ably and amusingly set out—Americans are not likely to change to a system like Canada's or, God forbid, the British NHS.

If Morrison is right then Arthur Seldon may have got it wrong. Seldon is a free market economist and founder of …

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