ABSTRACT
Current interest in the health care systems of other countries has been stimulated in part by the increasing recognition that the problems they face have much in common. At the risk of over-simplifying a complex picture, these can be said to relate to three factors. First, the costs of health care have risen continuously as demand has been swelled by demographic trends, epidemiological changes, technological development, and higher public expectations. Second, broad economic and political trends have served to restrict the supply of resources which governments and individuals have felt able and willing to make available. Third, health care services have apparently failed to produce a real, overall improvement in the health status of populations. There is no more than a tenuous relationship between formal health services and the health status of the population, which is affected as much by individual and collective economic well-being, diet, housing and occupation as by access to the services of professional healers. In other words, there is a fundamental incompatibility between the supply of resources for modern health care and the demands made on them, and ambiguity surrounding the contribution of health services to social well-being.
