Competition or regulation. A critical choice for organized medicine.

Abstract

THE NEXT few years are crucial for the future development of the health care system. Faith in the ability of command-and-control-type regulation to influence the practices of thousands of individual practitioners, let alone the costs of hospital care, is on the wane. Interest in the private sector, particularly market-oriented initiatives to encourage greater efficiency and better use of expensive facilities, is growing. Given the long-standing opposition of organized medicine to government regulation,1,2especially regulation that threatens to intrude on the sanctity of the physician-patient relationship, one would expect the American Medical Association to support this new direction in health policy. However, strong expressions of support have not been forthcoming. Instead, medicine seems to be on the horns of a dilemma. THE REGULATORY HORN On the one hand, organized medicine faces the now well-known route of more regulation of medical practice. As noted previously, this has not been the route