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This paper examines the right to health care. Various expressions of this right may be distinguished. These include both individual rights and social rights which could be based upon international treaties and constitutional rights. They may be found in national health legislation and, in some cases, in jurisprudence. To analyze the consequences of limiting the right to health care, a framework for judicial review has been developed which encompasses these expressions of the right to health care. The framework was used to examine legal and health policy developments in three Western and two Eastern European countries. In Italy and the Netherlands the right to health care is protected constitutionally (but on differing legal bases) while the United Kingdom does not have a written constitution. In contrast, Hungary and Poland have for many years seen the state take responsible for the provision, administration and allocation of health care services and the right to health care was guaranteed theoretically but not in practice because of the lack of (financial) means. However, the Polish Constitution explicitly anticipates possible limitations of the right to health care. What all these countries have in common is a cost containment perspective where the future will bring even tighter limits on what resources patients may consume. Despite differences in legal structure between these countries, where they seem to converge is on the consequences of putting limitations on the right to health care. The courts in Italy, the Netherlands and the UK have formulated conditions drawn from the acceptance that this right has to be judged within the context of limited resources. It may be concluded that finding a compromise between the right to health care and cost containment policies could also be an issue, Eastern European countries will have to face in the future. [ABSTRACT FROM AUTHOR]

The UK's National Health Service is approaching its sixtieth anniversary, an oppportune time perhaps to consider the case of the United States, where there is no national health service. Federal law requires hospitals to treat those who enter their emergency rooms, but not for free; military veterans are offered care in health facilities supported by federal tax dollars and the national Medicare programme provides government-sponsored health insurance for specified services to those over 65 years of age and to individuals certified as disabled. However, Medicare does not provide health services, which are predominantly purchased in the private sector. This article considers the history of American health care over the past 60 years, reflecting the diverse ways in which health care is embedded in the economy, politics, power structures and culture of the United States and discussing what it is like to have a health care industry without having a national health service or universal health insurance. The article concludes that, since the Second World War, the United States has been successful in achieving highly specialized, valued, life-improving health care for most--not for all--members of the population, but at a huge and rising cost. Notable achievements have been produced by the public-private mix of the American health enterprise. However, broad questions of social class, illness, insurance and the burden of payment for health care remain in a society with widening divisions of the population by socio-economic class, education, health literacy and computer skills. [ABSTRACT FROM AUTHOR]