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April 11, 1986

The Health Planning Predicament: France, Quebec, England, and the United States

Author Affiliations

School of Public Health The University of Texas Health Science Center Houston

JAMA. 1986;255(14):1942-1943. doi:10.1001/jama.1986.03370140140044

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Victor G. Rodwin, in his comparative study of health planning in France, Quebec, England, and the United States, argues that each has found itself in a considerable "predicament" as regards accomplishing its health planning goals.

The author offers a number of "formulations" of this predicament, such as, "No one quite knows what the future health care sector should look like or how to gain control over the health care system" (p 2) and "No one knows how to assure that the right patient receives the right service at the right time and in the right place; and even when a consensus is reached on what is 'right,' critical elements... are rarely implemented" (p 41). He also discusses the dilemma of "how to create a reimbursement system in the health sector that encourages hospitals and physicians to pursue the interests of society as well as their own" (p 59).

The solution