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January 30, 1978

Comparative National Policies of Health Care

Author Affiliations

Boston Hospital for Women Boston

JAMA. 1978;239(5):442. doi:10.1001/jama.1978.03280320058029

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As a long-time student of health care systems and with first-hand experience in 45 countries, Dr Milton Roemer, professor of Public Health at the University of California, Los Angeles, is an ideal person to summarize the widely variant nature of health care throughout the world. Because economics and economic philosophy determine the organization of health care, Dr Roemer has been able to simplify and categorize the forms of health care by their economic milieu into those of free enterprise (United States, Australia, Belgium), welfare states (Britain, Germany, Canada), underdeveloped countries (largely African states), and socialists (Eastern Europe, USSR, China). With these categories he characterizes and compares the aspects of health care among these groups of states—payment mechanisms, personnel and how they are trained, physical arrangements, organizational structure, functional process, statutory regulation, and planning arrangements. These are described and compared without judgment. One senses that to the planner the amorphous, eclectic,