In This Review

Public Health Policies and Social Inequality
Public Health Policies and Social Inequality
By Charles F. Andrain
New York University Press, 1998, 304 pp.

The past 40 years have seen massive improvements in health worldwide despite substantial institutional differences in providing health care. Just as one example, U.S. And British infant mortality has fallen by over 70 percent, while Japan's has dropped 86 percent. This informative book examines health care systems in eight industrial countries and evaluates them in terms of equality of treatment, efficiency, and customer satisfaction. The author classifies health care systems into three general categories -- entrepreneurial (United States, Canada), organic corporatist (France, Germany, Japan, Netherlands), and social democratic (Britain, Sweden) -- and outlines substantial differences in health care financing and provisioning among them. The author adopts a holistic approach to explain such variety, citing public decision-making, divergent interest groups, and cultural differences before concluding that there is no single correct way to provide this fundamental need. Unfortunately, the book would be more useful if it offered further information on such factors as waiting times, access to advanced medical techniques, technical innovation, and opting for outside treatment to assess the quality of different health care systems.