THE US VIEWPOINT

Health and medical care services are not yet subject to the laws of su pply and demand or the impersonal effects of the economic market. Howe ver, finite resources mean that governments and other payers are force d to make trade-offs. The United States, which has relied most heavily on market forces for its medical system, is now moving towards greate r government responsibility for organization and financing, if not del ivery, of services. President Clinton has proposed a national program of unified organization, service delivery, and financing so as to impr ove access to the US health care system and control cost. The proposed plan will enfranchise upwards of 50 million people who currently have no, or limited, access to medical care. Therefore, the initial effect s will be more care of all kinds being provided by physicians. Such in creases of services will increase expenditure, at least over the short -term.