England and Sweden have two of the most advanced systems of universal
access to health care in the world. Both have begun major reforms base
d on similar principles. Universal access and finance from taxation ar
e retained, but a measure of competition between providers of health c
are is introduced. The reforms therefore show a movement toward the ki
nd of approach advocated by some in the United States. This article tr
aces the origins and early results of the two countries' reform effort
s.