future time to extend the number of countries studied to determine if the conclusions reached here can be confirmed.The article begins with a discussion of who should pay hospitals and doctors and a subsequent exploration of the various modes of payment-first for hospitals, then for physicians. Thereafter, the article proceeds to brief examinations of two specific topics, patient cost sharing and closed-panel (HMO) enrollment. The conclusion proposes specific policies for paying hospitals and doctors under an American national health program.