Abstract
CLOSE observers of the health-care system, among them Arnold Relman1 2 3 and David Rogers,4 are alarmed at how fast American medicine appears to be turning from a profession into a business. The evidence of history and economics suggests that a related and more pervasive trend, the monetarization of medical care, has been proceeding apace for the past several decades and dominates the present scene.Monetarization can be defined as the rapid penetration since 1950 of the "money economy" into all facets of the health-care system. Its influence is reflected in the following developments: the order of magnitude of growth in the . . .