Rationing Medical Progress

Abstract

We are engaged in a great struggle to reform the American health care system, a system addicted to increasing costs and decreasing equity. The first tactic of someone suffering from addictive behavior is twofold: to try to remove the bad habit with the least possible disruption to the ordinary way of life, and to try to change the undesirable behavior in a painless, incremental way.This tactic rarely works, as any reformed smoker or alcoholic can testify. The price of real change is harsher self-examination and the revision of basic values and habits. With the health care crisis, we have . . .