Abstract
Medical cost containment has been compared to squeezing a balloon — constraining one end causes the other end to bulge. The relentless rise in national health care expenditures — estimated to consume over $700 billion and more than 12 percent of our gross national product in 1991 — has inspired numerous countermeasures. During the past two decades these have included creating incentives to join health maintenance organizations; utilization-review programs to curb unnecessary care; health planning constraints to prevent excess numbers of beds and unnecessary duplication of technology; price controls; malpractice reforms; coinsurance and deductibles to reduce patient demand; reductions in . . .