The NHS is centrally organized and administered by district offices that purchase health care services from private providers and NHS Trust hospitals. Under this hierarchy, the British system is one of the most efficient in the world. The allocation of health care resources is managed by a number of methods, ranging from delay to restrictions on available care. Unlike the United Kingdom, American courts are fairly active in supervising health care resource decisions. Although Medicare is a social insurance program, it provides fewer benefits than similar European systems.
Statutory provisions limit judicial review of national coverage and medical necessity decisions.
Courts are more active, however, in cases involving long term care. At the same time, the amount of private health insurance litigation has grown tremendously. Professor Jost concludes with ideas on means to maintain judicial oversight of health care resource allocation decisions while preserving efficient use of such resources. The United States differs from much of the world in trade policy towards Iran and Libya. Through the Iran and Libya Sanctions Act of 1996, it seeks to pressure other states to refrain from certain investments in the Libyan and Iranian economies.