Moderating the Rise in Health-Care Costs

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Abstract
A Pragmatic BeginningAs confidence wanes in both "regulation" and "procompetition" as panaceas to control health-care costs, even representatives of leading health-maintenance organizations are warning against competition.1 However, the latest buzz word, "tiering" — a euphemism for restoring the status quo ante Medicare and Medicaid and legitimizing a two-class system of care — is just as inappropriate as resistance to all change in the hope of maintaining the present status quo.Although it has suddenly become respectable to advocate a two-class system of care and to consign the elderly, along with the poor, to the lower class,2 such an approach . . .

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