Word: careful
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Dates: during 1970-1979
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...great optimism is justified either when it comes to cutting medical costs overall. Medicine cannot be made cheap, given the costs of its technology, and by its nature it cannot be anything but a seller's market. But U.S. health care bills do not have to shoot up as rapidly as they are doing now. The big question is whether doctors, hospital administrators, insurers and employers can devise ways to bring the public the benefits of technology at an affordable price, without a federal whip being held over them...
...That used to be true of medicine, too, in the now dimly remembered days when patients paid nearly all the bills out of their own pockets. No more: the saddest irony of the medical inflation is that it has been triggered largely by an effort to bring quality medical care within everyone's reach...
Unquestionably, this system has saved innumerable lives and improved the nation's health by encouraging people to seek medical care that they could not otherwise afford (few could without insurance: total payments to doctors and hospitals will work out to more than $3,500 this year for a typical family of four). But the system could hardly have been better designed to fan inflation than if that had been its purpose. It has in effect repealed for medicine the last vestiges of the law of supply and demand, a free market equivalent of the law of gravity, and made health...
...Association in 1937, has not rigorously questioned hospital bills until recently. Congress, when legislating Medicare and Medicaid, tacitly agreed to forget about cost controls as part of a bargain to keep the medical profession from opposing the program. Instead, one of the ways the Government reimburses hospitals for the care of Medicare-Medicaid patients is on a "cost plus" basis, and it asks few questions about the cost. Blue Shield and commercial insurers generally pay "usual, customary and reasonable" physicians' fees (U.C.R. in medical jargon). That gives doctors an incentive to charge all patients top dollar, so that they...
...lack of necessity to watch costs would be inflationary in any business. In health care it has been catastrophically inflationary, because powerful underlying forces?economic, psychological and technical?would be working to drive up bills even if a determined effort were made to hold them down. Among these forces...