Abstract
Economic, demographic, and technological pressures have led at the same time to increased demands upon health services and the need to contain spending on health care. As the United States has focused singularly on an array of market mechanisms, Western European countries have each adopted a broader set of strategies along with limited de-insurance: innovative regulatory approaches and a move from compulsory health insurance models to flexible national health service models of providing health care. Pursuit of cost-containment in Western Europe has proceeded along with pursuit of quality and, above all else, equity.
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