A concern about equity was one of the main motivating forces behind the creation of the National Health Service (NHS) in the UK. William Beveridge, the architect of the welfare state, argued for a health service which would provide treatment "to every citizen without exception, without remuneration limit and without an economic barrier at any point to delay recourse to it". Equity has remained a major goal within the UK system.
What happens abroad?
A concern about equity has also been reflected by other countries' approaches to health care. McGuire, Henderson and Mooney have pointed out that the introduction of public health insurance in Canada in 1971 "was explicitly stated to be motivated by a concern to make health care utilisation less dependent upon income". While Blewett has suggested that in Australia "The introduction of Medicare in February 1984 was designed to ensure that all Australians have access to medical and hospital services on the basis of need". Even in the US, which has the most market orientated health care system in the developed world, the state intervened to provide Medicare and Medicaid to help the poor afford health care.
Market versus State?
In practice the question is not a simple choice between a pure free market and a pure command system. Everybody agrees that health care markets fail to some degree and that there are equity considerations. But does this automatically mean society is better off with some sort of command allocation system where the State makes all the decisions? Government intervention also imposes costs and creates inefficiencies. For instance, management structures are often bureaucratic and inflexible, leading to outcomes which do not reflect consumer demand and which are wasteful.
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