ABSTRACT
This chapter is an attempt to contrast two distinct traditions in the analysis of medicine. The first places its emphasis upon the organisation of health-care at the national scale; the second focuses more firmly upon the distribution of resources at the local scale. In the first category can be found several distinct strands of emphasis. Alford, for example, has discussed in the American context the role of health institutions in the shaping of national policy. This chapter sketches the organisation of health-care in both the USA and the UK, in order to begin to reconcile these two distinct strands of medical and more general social science literature. Although health-care is most easily categorised as an aspect of consumption — part of the social wage — it would be negligent to overlook the fact that provision is also part of the accumulation process within capitalism; in other words medicine is not simply a service, but also a commodity.
