The health care systems of the US and the UK must both respond to concerns that have been central to policy makers for several decades: escalating health costs, seemingly inexhaustible consumer demand and fiscal retrenchment. Both systems, although very different, can learn from the other and should converge on middle ground. This report describes the main characteristics of the American health care market, defines the main structures and vocabulary of managed care and suggests ways in which the experiences of the American health care system might point to practical lessons for PCG/Ts in the UK as they take shape.