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Dear Colleagues The Centre for Studying Health Systems Change has released (March 21, 2002) this report, which can be accessed on-line at http://www.hschange.com/CONTENT/421/ Further coverage of the report can be accessed via American Medical News at http://www.ama-assn.org/sci-pubs/amnews/pick_02/gvsd0408.htm I attach below summary points "Despite unprecedented economic growth, low unemployment and fewer uninsured people, Americans’ ability to get needed medical care failed to improve significantly between 1997 and 2001, according to findings from the Center for Studying Health System Change’s (HSC) Community Tracking Study Household Survey. While most people get the care they believe they need, about one in seven Americans reported some difficulty obtaining needed care in 2001—about the same as in 1997. At the same time, health system-related problems—such as the ability to get timely appointments—increased, suggesting possible health system capacity constraints are emerging. On a brighter note, children’s ability to get needed care improved." Best wishes David McDaid LSE Health and Social Care