ABSTRACT
The emergence, consolidation and growth of the Welfare State has had profound implications for the practice of medicine and the structure of health care. Examination of the total physical resources allocated to health care suggests that there are substantial underlying differences between the developed economies. The national health insurance legislation of 1911 appeared to humiliate the British Medical Association, but the scheme was relatively generous in protecting the autonomy of doctors; also the capitation fees, as implemented, were higher than originally proposed. The humiliating defeat inflicted on national health insurance in 1948 effectively ruled this option out of court permanently. Health services were the most contentious province of the welfare state empire, and implementation of the Second World War policies for universal and comprehensive health care was pitifully slow. In comparative studies, the USA is usually contrasted with Europe for its consistent resistance to national health insurance, and the continuing dominance of occupational or corporate welfare provisions.
