Building Better Health
Jill McGivering investigates if there can be a health system which provides universal access, quality care and a healthier population at an acceptable price.
With the pressures on health spending (ageing populations, medical advances and more treatments, different diseases), is it possible to meet everyone's needs and achieve a goal of universal access while keeping costs under control?
How should a health system work? Has the world learnt any basic lessons from past triumphs and mistakes?
How does a government make sure every citizen, rich or poor, has the medical care they need? Who should employ doctors and nurses and run hospitals and clinics? The taxpayer or the private sector?
Jill McGivering compares two very different health systems in the developed world: England's National Health Service and that of the US State of Massachusetts.
The NHS was launched 60 years ago, fuelled by a strong vision of social change.
It promised universal health care for all, rich or poor, free at the point of delivery.
Since then, funded through general taxation, it's struggled to cope with rising costs and constantly growing demands.
So is it failing or surviving? And how should it adapt to cope with future challenges?
In the US, health care is driven by private insurance.
That means high quality care for those with cover - but leaves about 40 million Americans completely uninsured.
Now the State of Massachusetts is engaged in a pioneering experiment to give everyone insurance, with government subsidies for those who need them.
Is the experiment working - and could it even be the future for the whole of the US?
First broadcast on 16 July 2008.