Democratic
Society-Undemocratic
Medicine: Limited Resources in Medical Care
Burton A. Weisbrod
Abstract
Soaring costs have thrust health care into the political
debate of every economically advanced country. The escalation of
expenditures is being accompanied by increasing pressures on governments
to confront what appears to be a dilemma -- either accepting the
rising expenditures on health care, or restricting access to health
care.This paper addresses the question of what has brought most
of the world to this tragic choice and financial brink. It argues
that: (1) The most important force driving health care expenditures
upward has beentechnological change, and (2) the particular pattern
of technological change that has occurred was not inevitable, but
was caused inadvertently by public policies operating through the
health insurance system. Looking to the future, I consider whether
the course of technological change in health care will be different
from what it has been in the past, and whether it will reduce upward
pressure on expenditures; I forecast that it will not. The paper
also deals with a second question: No matter what generated the
present predicament, is there a way out? Two avenues are examined
-- changing the direction of technological change, and using health
care resources more efficiently, recognizing that policies that
appear to be cost decreasing may well do the opposite.
Burton A. Weisbrod, Department
of Economics, Northwestern University
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