Are National Health Services Systems Converging? Predictions for the United States

Abstract

A review of the emerging literature on cross- national health services systems and first hand studies by the author reveals that health services systems in many coun tries are converging in their egalitarian objectives, organiza tional forms, methods of paying providers, scope of services, and costs controls. Cross-nationally facilities and personnel are quite similar, indicating the importance of medical tech nology as a shaping force. Organizational forms, methods of payment, and sources of funding differ widely because these are mainly social and political expressions, but these too, are converging. Countries will continue to exhibit differences in structuring inherent in their economic and political styles, from the United States to the U.S.S.R. It is proposed that the range of difference will narrow, but not converge. Several issues are examined cross-nationally: equity, scope of ser vices, financing and cost controls, organizational structure, and planning. Finally, predictions of developments in the United States are made from experiences in other countries, and from the social, economic, and political style of the United States.