title: The catch-22's of cost containment.
abstract: While exploring the problem of escalation of health care expenditures in urology and analyzing various means to curtail this escalation, we noted a recurrent problem relating to the negative incentives inherent in presently used reimbursement mechanisms. Proposed solutions to a particular problem usually are accompanied by new economic difficulties arising from the solution. A series of Catch-22's are encountered in many different problems concerning economic health care delivery. We herein elucidate a number of these problems and propose a novel reimbursement system in which there are positive incentives provided to those urologists who make an honest effort at cost containment.
mesh_terms: D002017:Budgets; D003363:Cost Control; D003362:Cost-Benefit Analysis; D003365:Costs and Cost Analysis; D004209:Disposable Equipment / Q000191:economics; D004469:Economics, Hospital; D005102:Health Expenditures; D006739:Hospital Administration; D006760:Hospitalization / Q000191:economics; D006801:Humans; D007349:Insurance, Health, Reimbursement; D012040:Regional Health Planning / Q000191:economics; D012051:Reimbursement Mechanisms; D014481:United States; D014572:Urology