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The United States Needs a Health System Like Other Countries

Michael F. Loudon, BM, BCh
JAMA. 1994;271(19):1480-1481. doi:10.1001/jama.1994.03510430032017.
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To the Editor.  —Dr Glaser's article1 on the virtues of a national health system for the United States is but the latest fine example in a superb series that JAMA readers from other countries must surely read with fascination and admiration. His conclusions are clear and compelling.However, his article contains three important related generalizations, placed for maximum rhetorical effect, two of which are at best misleading and one of which is false.Glaser states that "in other countries... [governments do] not simply dictate to the drug companies, wholesalers, and pharmacists." On the subject of cost control (both global and local) Glaser states, "In democratic societies, no single government agency... can fix a limit.... [A] limit cannot be set by a snap of the fingers...." The government of the United Kingdom does dictate to drug companies and distributors. It sets global and regional budgets that impact irrevocably on all


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