The health of 900 children in foster care was assessed through a review of 257 medical charts and an examination of a subsample of 35 children. Although major handicapping conditions among the children were well cared for, prevention, the care of minor conditions and emotional problems, and overall coordination of care were found to be lacking. On the basis of these findings, the authors propose how health care delivery to foster children can be improved.
The Province of Quebec and the United Kingdom have both a strong system of medical manpower regulation. Growth of the number of doctors--and consequently of health expenditures--is kept under control. Shortage of supply of health services increases the queuing process. In the two countries, the main problem is not how to curb health costs but to cope with the unmet demand. In Germany, the control of medical school intake is very weak. However, agreement of young doctors by the Sickness Fund is strictly controlled, the Fund having the right to close the list of "agreed physicians" in areas or specialties where doctor surplus is observed. In Belgium, a numerus clausus system is established very recently for medical school intake. In the USA, the health care system is traditionally regulated by the market forces. The strong increase of health expenditures during the recent decades has shifted the power from the medical profession to the paying bodies (HMO, MCO...) who are now supporting the emergence of new health personnels, less costly.