Abstract
Debate about whether to restrain health care spending is intensifying. Much of the debate revolves around efficient research allocation. The possible impact of cost control on the advance of medical technology merits more attention. Public and private efforts to slow growth of health spending have not enjoyed much success. Most recently, managed care failed because administrators lacked political legitimacy. Politically established budget limits can hold down spending, but the United States seems unwilling to adopt them; even if it were, the technology to administer them rationally does not exist. In this situation, efforts to hold down cost growth carry grave risks.

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  • Introduction
    Published by Oxford University Press (OUP) ,2001