summarize The 4 nations all use public authority and planning to control the number and distribution of hospitals and physicians. Contrary to conventional wisdom, such constraints do not necessarily make the system "smaller" or harder to access. Rodwin's Table 2,3 for example, shows that on most measures of resources and utilizationfor instance, active physicians per thousand population; total inpatient hospital beds, physician visits, and hospital days per capita; admission rates to and lengths of stay in hospitalsFrance surpasses the United States. These limits do make the systems less specialist driven and technology intensive, however, which seems to be how they register savings for the nations in question. Notwithstanding such programs as certificates of need, the United States relies mainly on a combination of market forces and professional preferences to decide what levels of supply are adequate. The market itself must challenge the hoary conviction that "health is a community affair," meaning in practice a highly entrepreneurial affair in which local providers behave as if more is better, often with the acquiescence of boosterish local business leaders. Hospitals and physicians want bigger and better facilities, the latest and best equipment, deeper market penetration, and more accessible satellite sites, as do the