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This paper examines the recent development of the private medical sector in Britain. It argues that while the present Government has acted to bolster the fortunes of private medicine, electoral considerations have formed an obstacle to the pursuit of more radical policies. Nevertheless, the private sector has grown considerably since 1979, which is in some measure due to the favourable climate induced by Government policy. The core features of the private sector are defined and the nature of its provision discussed. It is suggested that the private sector is undergoing a process of commercialisation similar in kind to that which has occurred in the health industry in the USA and partly in consequence organisational features of US health care are gaining currency among supporters of privatisation.

This article examines the medical care sector in New York City in the wake of that city's fiscal crisis. Against a changing national background of medical care politics, it describes existing inequalities and distortions in the medical care system, a system whose inequities are partially reinforced by federal and state intervention. The process of subordination of the 'place-of-last-resort' public sector is defined. Although attention on this sector is justified, the service crisis of the medical care sector is more correctly to be seen as one afflicting all those services used by minorities and the working class. The policy of retrenchment in New York is seen as a prelude to Reagan's austerity programme, and calls for reassessment of current health activism.

In his article in this issue Vicente Navarro augments his presentation on the global nature of the crisis of social welfare under capitalism with a financial summary of the Reagan budget (for fiscal year 1981/82). This article adds additional flesh to Navarro's discussion through an examination of some of the critical details as well as wider implications of the Reagan budget, particularly as it affects recipients of social welfare programmes for the coming period

In Europe, concerns about obesity have been stimulated by trends in several member states, raising challenges for multilevel governance. This paper gives a picture of obesity in Europe, pointing to variations between and within countries. It discusses the various explanations of generalized weight gain, and the policy levers that might tackle it, the paper also maps current policy responses. Policy considerations raised include financial burdens, health-care management, social inequalities, cultural issues, welfare support, and farm and food industry drivers. The paper proposes that obesity is unlikely to be reduced unless it receives both multi-level and multi-field analysis and intervention. In this context, action in Europe is hampered by a fragmented institutional architecture at all levels of governance. It also raises serious questions about the unequal relations between the state, the market and civil society within Europe. The paper concludes with a suggestion that obesity warrants improved European linkages across discrete areas of policy.