HEALTH CARE FINANCING: The Next 50 Years by Empire Blue Cross & Blue Shield


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Timely perspectives on some urgent socioeconomic issues. Cost-containment efforts and equitable allocations of available resources dominate contributors' agendas. In reviewing current trends, for example, Richard Berman (of NYU's Medical Center) notes that in 1984 America's bill for health care came to about $400 billion, 14 percent of the GNP; by the turn of the century, he estimates, the tab could approach $2 trillion, or $7,000 per capita--against a world-beating $1,500 in 1984. Eli Ginzberg (Columbia Univ.) agrees that outlays are likely to continue spiraling upward, owing to an oversupply of physicians, and hospital beds, the reluctance of Congress to cut Medicare benefits, and other factors, including the emergence of new life-prolonging technologies. Nor is he optimistic that highly touted HMOs will reduce either total costs or hospital admissions. Theodore R. Marmor and Dr. George R. Silver (both of Yale) offer three alternatives designed not only to curb runaway costs but also to provide health-care services to uninsured and/or have-not constituencies; in sorrow, though, they conclude that professionals have precious few incentives to mend their ways, in part because of the varying payment policies of third parties--like Blue Cross and Medicaid. On the other hand, Dr. Kenneth W. Woodward, manager of clinical services at Xerox Corp., predicts that business will soon be playing a more active role in the delivery of services it supports financially. By contrast, Theodore Bernstein, director of the ILGWU's benefits program, commends a genuinely national system akin to that now operating in Canada as a cost-effective replacement for the expensive patchwork arrangements which now prevail. Overall, a realistic if not reassuring appraisal of health-care inflation and its consequent discontents.

Pub Date: Jan. 10th, 1986
Publisher: Empire Blue Cross and Blue Shield--dist. by Rockefeller Univ. Press