This book is the product of 10 years of research into the health care systems of the U.S.A., Sweden and England.
The author sets out to show that " the health services organizations in the United States, Sweden, and England have emerged in response to certain dominant factors in their respective societies and with, so far, little directed planning in any controlled sense ".
Evidence is assembled to show how rational organizational goals are modified to conform to the prevailing social system. The universal objective-equality of access to medical care regardless of income or place of residence-is thus never achieved.
The author compares indicators of health and of health resources, the use that is made of resources, and financial and social trends. The historical development of current social, political and economic thought in the 3 countries is also studied, in an attempt to find a relationship with the differing health care systems.
An intimate knowledge of the 3 health care delivery systems is evident, and there are copious footnotes, quoting many of the sources listed in a bibliography of some 300 references. In an appendix of tables, demographic and financial data, personnel and facilities, and vital statistics from the 3 countries are compared.
An observation that England has the least flexible system of the 3 appears to undervalue the forthcoming re-organization of the National Health Service in 1974. The author predicts an even more structured system, with a continuing " tradition of niggardly financing of public health and welfare programs " occasioned by a majority reluctant to agree to a reduction in its living standards. Whether (his and other somewhat pessimistic forecasts for all 3 countries are realized, remains to be seen.
The book is thought-provoking. It bridges the gap between the health scientist whose work is based mainly on measurement and the one who writes on concepts without supporting data. Michael Ball.
This book is the product of 10 years of research into the health care systems of the U.S.A., Sweden and England.The author sets out to show that " the health services organizations in the United States, Sweden, and England have emerged in response to certain dominant factors in their respective societies and with, so far, little directed planning in any controlled sense ".Evidence is assembled to show how rational organizational goals are modified to conform to the prevailing social system. The universal objective-equality of access to medical care regardless of income or place of residence-is thus never achieved.The author compares indicators of health and of health resources, the use that is made of resources, and financial and social trends. The historical development of current social, political and economic thought in the 3 countries is also studied, in an attempt to find a relationship with the differing health care systems.An intimate knowledge of the 3 health care delivery systems is evident, and there are copious footnotes, quoting many of the sources listed in a bibliography of some 300 references. In an appendix of tables, demographic and financial data, personnel and facilities, and vital statistics from the 3 countries are compared.An observation that England has the least flexible system of the 3 appears to undervalue the forthcoming re-organization of the National Health Service in 1974. The author predicts an even more structured system, with a continuing " tradition of niggardly financing of public health and welfare programs " occasioned by a majority reluctant to agree to a reduction in its living standards. Whether (his and other somewhat pessimistic forecasts for all 3 countries are realized, remains to be seen.The book is thought-provoking. It bridges the gap between the health scientist whose work is based mainly on measurement and the one who writes on concepts without supporting data. Michael Ball.
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