In this well-documented book, Alain Enthoven develops the ideas of consumer choice and managed competition of alternative health care financing and delivery systems, as well as describing ways to improve quality and reduce the cost of health care. He demonstrates how these ideas could be applied in the American employment-based health insurance model, how similar ideas have been introduced in the British National Health Service; how these ideas have been applied in the Netherlands; and the need for integrated comprehensive care systems. This unique anthology traces the development of two important and related themes. Firstly, the 'output' of the health services industry has been produced by disaggregated physicians, nurses and other health professionals, hospitals, drugs and device companies that somehow combine to serve the patient. Progress in quality and the economy requires the services of these components to be integrated into coherent systems in which the incentives of all...

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