[The health of developed countries: which is the most cost effective delivery system?].

: Several attempts have been undertaken to classify national health care systems according to their merits. The best known is the one published recently by the World Health Organization. The works conducted by the author have produced an other one. Among developed countries, it appears that the model they have adopted--that of Chancelor Bismarck (health services financed by contributions from employers and employees) or that of Lord Beveridge (health services financed by taxes)--does not play a crucial role. Universal access to health services and their provision free of charge do not automatically guarantee equity and efficiency. Equity means that the same treatment is applied to everybody. Efficiency means that health expenditures are kept under control, taking into account the health results obtained. In this respect, the USA are ranked at the lowest level, whatever the classification system used.