REFORMING THE HEALTH-CARE SYSTEM - THE UNIVERSAL DILEMMA

This Article surveys alternative approaches by which the advanced indu strialized nations seek to cope with the twin problems that health car e poses everywhere: the provision of universal access to health care a nd the control of national spending on health care. Although approache s to these twin problems vary considerably among nations at this time, there may well be a convergence toward a common approach in the next century. Under that approach, all health care systems will be subject to top-down global budgets and will put their health care providers in to ''statistical fishbowls'' that reveal just how effectively these pr oviders allocate the global budgets at their disposal.