Focus: Washington – US medicine marches slowly toward UK solution

BMJ 1997; 314 doi: (Published 25 January 1997) Cite this as: BMJ 1997;314:247
  1. John Roberts

    Medical systems in the United States and United Kingdom are increasingly mirroring one another–that is, they look alike but in opposite ways. In the UK medicine is a public endeavour that more and more uses private sector schemes. In the US it is a private endeavor that increasingly is being shaped by public policy.

    At the top of the US medical agenda this year is Medicare (public insurance for all the elderly) and Medicaid (public insurance for the poorest, especially children). Both programmes are growing much faster than inflation, and Medicare is expected to be broke by 2001.

    As a result, patients in both programmes are being pushed strongly toward managed …

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