Rationing Hospital Care: Lessons from Britain

Resistance to the decades-long rise in the cost of hospital care in the United States is growing rapidly. In consequence, all physicians and patients soon may have to live with, and within, a system that limits expenditures. The process has, in fact, already begun. Fixed per diem reimbursement, reimbursements according to specific diagnosis, and overall revenue limits are currently being implemented by several states or by the federal government under Medicare. In addition, many businesses are pursuing cost containment through so-called preferred-provider organizations. It is unclear how far our efforts to control hospital costs will go, but one thing is . . .