ABSTRACT
The studies of both Great Britain and Canada provide new evidence of problems with centralized medical systems. According to its supporters, the Canadian medical system has brought medical care within the reach of all Canadians by eliminating the price barrier. Canadian experience with government medicine has been shorter, and such trends are more difficult to identify. The provincewide fee schedules adopted by Canadian national health insurance (CNHI) eliminate compensating price differences, a part of the natural pattern of fees under a market system. Calculations of the cost of CNHI should also include consideration of its effect on the quality of care delivered. The problems with the British National Health Service (NHS) in practice are different but no less troubling. Evidence of NHS performance in the organization of supply is perhaps even more discouraging. A major improvement in the allocation of resources promised by the NHS was a more equitable geographical distribution of hospital resources.
