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American Journal of Public Health logoLink to American Journal of Public Health
. 1991 Dec;81(12):1566–1570. doi: 10.2105/ajph.81.12.1566

Lessons from London: the British are reforming their national health service.

A Vall-Spinosa 1
PMCID: PMC1405287  PMID: 1746650

Abstract

In an effort to keep abreast of the changing needs of a more affluent society and to ensure better value for money, the British are reforming their National Health Service. They are promoting competition and entrepreneurship, and directing funding to follow a patient rather than flowing directly to institutions. British physicians are resisting these changes. The United States, in the middle of a health care crisis of its own, can learn a great deal from Britain, especially in the area of controlling expenditures. The low cost of the National Health Service can be attributed to four major factors: (1) It is general practitioner driven and no patient accesses a specialist or hospital directly. (2) Hospitals, which employ all the specialists and supply most of the technology, operate on very tight, cash-limited budgets. (3) Administrative costs are very low. (4) The expense of malpractice is not (yet) a major concern. Changes occurring in both countries foretell a future wherein our health care systems may look very much alike.

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Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Fuchs V. R., Hahn J. S. How does Canada do it? A comparison of expenditures for physicians' services in the United States and Canada. N Engl J Med. 1990 Sep 27;323(13):884–890. doi: 10.1056/NEJM199009273231306. [DOI] [PubMed] [Google Scholar]

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