ABSTRACT
All health systems face problems of rising costs, increasing aging and dependent populations with fewer younger carers, and escalating costs of new forms of medical treatment and technology. Increasing public expectations of health and disease care lead to demands for the latest and most modern services. The shape of health and socio-economic systems is strongly influenced by: national philosophies; wealth and economic systems; geography, population density and infrastructure; demography. Gradual evolution of health care systems has always been more successful in countries with stable social systems than radical revolution. In the UK, the primary physician is the 'general practitioner'; an independent contractor with the National Health Service, not a salaried employee. All health systems face similar problems with increasing demands for limited resources. The basic services provided are similar in all health care systems. Public satisfaction with health care appears to be lower in the US and in the UK was strongly associated with the strength of primary care.
