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David M. Eddy, MD, PhD

JAMA. 1993;270(4):520-526.

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

HOWEVER the debate on national health care reform comes out, and whatever strategies are eventually used to achieve the seemingly incompatible goals of providing universal access, improving quality, and controlling costs, one thing is certain: The day-to-day decisions of those who actually provide health care will be put under ever-increasing stress. Reform will not solve the problems that have been causing the pressure on physician decision making over the last decade; it will rely on further pressure to solve the problems.

We know this will occur for several reasons. Begin with the fact that of the three main goals of health care reform— access, quality, and cost—the driving force is cost. To be more precise, the driving force is the rate of increase in costs—the fact that health care costs have been rising at about twice the rate of inflation. It is this feature of health care that has transformed . . . [Full Text PDF of this Article]

Author Affiliations
Duke University Durham, NC

Footnotes
Reprint requests to Skyline Route, Box 32, Jackson, WY 83001 (Dr Eddy).

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