The prospects for health services in the United States

The enormous variety of diagnoses and prescriptions for dealing with the health care crisis in the United States can be simplified and clarified by reference to four logically distinct models of methods for organizing the production of health services. The assumptions of the free market model, the bureaucratic planning model, the professional model and the cooperative equalitarian model are described, as are the characteristic pathologies connected with the form those models take in reality. The intrinsically expansionist character of the manufacturing, service and consumer segments of the U.S. health system is described and the suggestion made that legislative attempts to contain costs will lead to increased bureaucratization primarily at the expense of the consumer.