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Perspectives on Cost Containment

Victor R. Fuchs

JAMA. 1993;269(5):631-633.

	Since this article does not have an abstract, we have provided the first 150 words of the full text PDF and any section headings.

THERE is a widespread belief in the United States that expenditures for health care are too high and growing too rapidly. This belief has stimulated numerous policy proposals for "cost containment," including such diverse approaches as managed care, managed competition, insurance company regulation, diagnosis related group reimbursement, global budgets, and expenditure caps. The pros and cons of alternative approaches to cost containment have been debated extensively; I have no intention of proposing still another plan. Instead, I shall offer a framework for thinking about cost containment that is applicable to all possible proposals. In developing this framework I will first consider why public policy should pay any special attention to health expenditures. Two popular explanations—share of GNP (gross national product) and effect on global competitiveness—will be examined and rejected; then three valid explanations will be discussed. Finally, I will show why every approach to cost containment requires pain if there . . . [Full Text PDF of this Article]

Author Affiliations
From the Departments of Economics and Health Research Policy, Stanford University, and the National Bureau of Economic Research, Stanford, Calif.

Footnotes
This article was presented as The Seventh Annual William Campbell Felch Lecture, sponsored by IMCARE, at the 36th Annual Meeting of the American Society of Internal Medicine, October 15, 1992, Honolulu, Hawaii.

Reprint requests to National Bureau of Economic Research, 204 Junipero Serra Blvd, Stanford, CA 94305-8715 (Mr Fuchs).

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