ABSTRACT
A strong voluntary health insurance movement had developed in Europe, out of which compulsory health insurance was later to develop. Organisations of working men, often developing out of the guilds, pioneered the system. In Britain, compulsory health insurance also involved the extension of an existing system - that of the friendly societies, many of which had by this time become large and politically powerful national organisations. Underlying the different provisions for health care are differences of national values and differences in the political influence of different actors - doctors, trade unions, employers and consumers. Health care has always been regarded as more of a right in Western Europe than in the United States. Charitable bodies provided the bulk of acute hospital care until the National Health Service was established in 1948. Environmental health services were also started and campaigns to combat the main infectious diseases.
