Medical Care in Three Societies

Abstract

The availability and accessibility of medical care in order to achieve and maintain health is now accepted as a human and civic right.

The provision of medical care is full of problems and dilemmas that are common to all nations and to all systems. There is an insoluble equation of wants, needs, and resources. The common goal and challenge facing all nations is how to make the best use of available resources.

Faced as we are with common problems and common goals, it is useful to examine and compare the ways in which three societies, Soviet, American, and British, have gone about organizing their medical services. The author, a British general practitioner, has carried out a comparative study based on a series of visits to the three nations.

Although the detailed form and structure of the services depends on national characters and on local social, economic, political, and geographic factors, there are within each and every system recognizable levels of care and administration and it is possible therefore to compare and contrast the three systems at these levels.

The findings reveal that there are many more similarities than differences, but what does emerge is the need to examine some of the differences to see, if they are successful in one system, whether they might be more widely applied.

There is a need, for example, to examine the ways in which the medical assistants (feldshers) are used in the U.S.S.R. There is a need to reexamine the needs at the first-contact primary level of care, and in particular the place of the “specialoid” or generalist physician.

This paper is more a plea for further studies and exchanges in comparative international studies than a definitive statement.