Observations on "Cost containment and new priorities in the European community" by Brian Abel-Smith.

A commentary on the article by Brian Abel-Smith briefly explores why the United States lags behind Europe in controlling health care costs. Three important factors are, first, that until recently the real cost of health insurance was not apparent to U.S. workers and political leaders; second, Americans prefer to try competition before resorting to other strategies; and third, responsibility for financing health care is divided among a large number of independent entities, while government regulation is split between the state and federal levels. At the same time, governments and private insurers in the United States have developed new health delivery structures and reimbursement mechanisms that the Europeans may find useful. A convergence of the two systems would be to the benefit of both.