Ron J. Anderson, MD
JAMA. 1987;258(16):2294-2295. doi:10.1001/jama.1987.03400160148047.
Text Size: A A A
Published online

After nearly seven years of steadily increasing competition and the promotion of market forces in the health care industry, public policy measures designed to curb health care costs are failing. Since 1981, the administration's policymakers in Washington have pursued legislation and regulations to encourage competition in the health care field in order to bring the cost of health care under control. It was thought that the discipline of the marketplace and free market forces would encourage hospitals and physicians to bring their charges in line.

The Medicare program has been radically changed to encourage cost containment. Some of these changes were overdue, but the prospective payment system has produced deleterious effects as well. Cross-subsidization of nonpaying patients by paying patients, once a fundamental principle of the industry, is no longer fashionable or accepted as good business.

Resources are being diverted from expensive inpatient services to less costly ambulatory care settings.


Sign In to Access Full Content

Don't have Access?

Register and get free email Table of Contents alerts, saved searches, PowerPoint downloads, CME quizzes, and more

Subscribe for full-text access to content from 1998 forward and a host of useful features

Activate your current subscription (AMA members and current subscribers)

Purchase Online Access to this article for 24 hours




Meets CME requirements for:
Browse CME for all U.S. States
Accreditation Information
The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
Note: You must get at least of the answers correct to pass this quiz.
You have not filled in all the answers to complete this quiz
The following questions were not answered:
Sorry, you have unsuccessfully completed this CME quiz with a score of
The following questions were not answered correctly:
Commitment to Change (optional):
Indicate what change(s) you will implement in your practice, if any, based on this CME course.
Your quiz results:
The filled radio buttons indicate your responses. The preferred responses are highlighted
For CME Course: A Proposed Model for Initial Assessment and Management of Acute Heart Failure Syndromes
Indicate what changes(s) you will implement in your practice, if any, based on this CME course.
Citing articles are presented as examples only. In non-demo SCM6 implementation, integration with CrossRef’s "Cited By" API will populate this tab (http://www.crossref.org/citedby.html).


Some tools below are only available to our subscribers or users with an online account.

Sign In to Access Full Content

Related Content

Customize your page view by dragging & repositioning the boxes below.