Rationing health care: the choice before us.

Rapid technological advances and upward pressure on wages of hospital personnel are leading to a steady increase in health care spending that is absorbing an ever-larger fraction of gross national product. Eliminating inefficiencies in the system can provide brief fiscal relief, but rationing of beneficial services, even to the well-insured, offers the only prospect for sustained reduction in the growth of health care spending. The United States, which has negligible direct experience with rationing, can learn about choices it will face from the experience of Great Britain where health care has been rationed explicitly for many years.

[1]  P. Lee,et al.  Economic and policy implications of early intervention in HIV disease. , 1989, JAMA.

[2]  C. J. Rosenquist,et al.  The introduction of low-osmolar contrast agents in radiology. Medical, economic, legal, and public policy issues. , 1988, JAMA.

[3]  J P Poullier,et al.  International health spending and utilization trends. , 1988, Health affairs.

[4]  D. Kanouse,et al.  The appropriateness of performing coronary artery bypass surgery. , 1988, JAMA.

[5]  R. Brook,et al.  The appropriateness of carotid endarterectomy. , 1988, The New England journal of medicine.

[6]  A. Wing,et al.  Prediction of resources needed to achieve the national target for treatment of renal failure. , 1987, British medical journal.

[7]  W. Schwartz.  The inevitable failure of current cost-containment strategies. Why they can provide only temporary relief. , 1987, JAMA.

[8]  D. Himmelstein,et al.  Cost without Benefit , 1986 .

[9]  W P Welch,et al.  Health care utilization in HMO's. Results from two national samples. , 1985, Journal of health economics.

[10]  Cox Je,et al.  Healthy lifestyles for Greenville, N.C. , 1985 .

[11]  W. Manning,et al.  A controlled trial of the effect of a prepaid group practice on use of services. , 1984, The New England journal of medicine.

[12]  C E Phelps,et al.  Some interim results from a controlled trial of cost sharing in health insurance. , 1981, The New England journal of medicine.

[13]  W. Schwartz.  The regulation strategy for controlling hospital costs. , 1981, The New England journal of medicine.

[14]  P. Joskow,et al.  Duplicated hospital facilities: How much can we save by consolidating them? , 1980, The New England journal of medicine.

[15]  J. L. Grand,et al.  The Distribution of Public Expenditure: The Case of Health Care , 1978 .