Cardiology and cost control: the ethical challenge for the new millennium.
Government interventions in the health care sector threaten the traditional role of physicians, since they are increasingly forced to consider the cost of medical care when making decisions on behalf of their patients. To prepare themselves for this ethical challenge and to actively participate in the debate about cost containment, physicians need to understand how health economists and politicians view the problem of rising medical costs. This review summarizes some essential facts and findings of the health economics literature that provide the rationale for different approaches to cost containment. The effects of rapidly growing health care cost on the economy are discussed, and improvement of medical technology is identified as the driving force behind this growth. The different policy instruments, which can be employed for cost containment, are explained against this background with an emphasis on Managed Care and global budgets. The outlined concepts are finally discussed in the context of the current debate about the proposed cost containment legislation in Germany.
Mattke
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Harvard School of Public Health, Department of Health Policy & Management, Boston, MA 02115, USA. smattke@hsph.harvard.edu
D002017:Budgets; D002170:Canada; D002309:Cardiology / Q000191:economics*; D003363:Cost Control; D003365:Costs and Cost Analysis; D004992:Ethics, Medical; D005858:Germany; D017048:Health Care Costs; D015276:Health Care Rationing; D018166:Health Care Reform / Q000191:economics*; D005102:Health Expenditures; D006291:Health Policy; D008329:Managed Care Programs / Q000191:economics*; D014481:United States