Should the NHS look to the USA for a new paradigm?

Abstract

This article presents the perspective of a doctor working with adults with learning disabilities in the USA public sector who has been observing the UK government’s ambitions to move toward a more market-driven healthcare system. Problems associated with the culture of market-driven healthcare in the USA are explored to unveil compounded dimensions of complexity within; some posed by deeply entrenched cultural and socioeconomic variability between states. For the observer, generalisation from explorations of such a system becomes exquisitely problematic and particularly confounding with respect to social service policy. One element does emerge as consistent between ideological opinions pertaining to social responsibility and public health in both the UK and USA—both seem to rely more on the political leanings of the observer, rather than his/her particular geographical location.