[Correspondence] The politics of reform of NHS dentistry

Not since the birth of the National Health Service (NHS) has dentistry received so much attention from politicians. The NHS is mentioned in manifestos and discussed on the doorstep. A recent Comment by Richard G Watt and colleagues1 criticised the English Government's recovery plan as out of scale with the velocity and extent to which the system is failing. The Comment called for “bold and ambitious” reform,1 including replacing the NHS dental contract and increasing funding (estimating that ...

[Correspondence] The Taiwan health-care system: approaching a crisis point?

Taiwan is one of the few countries where citizens enjoy universal health care, which is managed by the Taiwan National Healthcare Insurance (NHI) system. The NHI system, established in March, 1995 by the Taiwan Government, has provided high-quality health care with low insurance premiums. The average monthly insurance premium the typical Taiwanese citizen pays is NT$1377, which is approximately US$42.1 Such a low health-care expense ensures equitable access for all 23 million Taiwanese citizens.

[Editorial] Health priorities for Kamala Harris

The Democratic National Convention begins on Aug 19 in the wake of President Joe Biden's seismic decision to leave the presidential race. The Biden administration—including Kamala Harris—deserves great credit for bringing stability to the country after the attack on the US Capitol instigated by Donald Trump as well as for a health agenda that included reinstating both financing for WHO and the UN Population Fund and the US's role in the Paris Climate Agreement, introducing an expanded child t...

[Correspondence] Continuing challenges to health equity in Ireland

The Lancet Editorial on health equity in Ireland1 presented an unduly rosy perspective on proposed moves towards universal health care coverage, particularly in the hospital and outpatient sector. Public hospitals currently operate a practice of mixed private and public patient care. The new contract for hospital consultants is not, as stated in the Editorial, for public hospitals only: it limits practice in public hospitals to public patients only but permits unlimited off-site practice in t...

[Correspondence] The Italian health-care crisis—only a matter of funding?

Having noted that Arianna Magon and Rosario Caruso erroneously refer to the Italian National Health System (INHS) in the title of their Correspondence,1 we would like to note that in Italy we also have a public National Health Service (NHS) mostly funded by taxpayers,2 which was initiated in 1978 in the wake of the English NHS and should provide universal coverage. A widespread weakness of the INHS throughout the country that is not underlined in the Correspondence is primary care. Although g...

[Correspondence] Europe has much to do to improve the quality of and access to safe pain management

We have read with interest the debate surrounding opioid use in the USA and related deaths. We also welcomed the different perspectives of Gerard A Kalkman and colleagues,1 concluding that universal health care and addiction care in Europe contributes greatly to preventing an opioid epidemic of US proportions. If we agree with many points, we respectfully disagree that this prevention is homogeneously helping to prevent such a crisis development. The authors mentioned only the opioid crisis i...

[Correspondence] The effect of Medicare for All on rural hospitals

Alison Galvani and colleagues1 robustly modelled the effect of the Medicare for All Act on US national health expenditures and outcomes. Spending on hospital care and physician or clinical services accounts for 53% of total spending. Their model assumes that Medicare rates are uniformly 22% lower than are private-payer rates and that, by switching all fees to Medicare rates, overall reimbursements will be 6% lower for hospitals and 7% lower for physicians.