Variations data and the regulatory rationale.

Abstract

Prologue: Knowing that wide variations in the use and cost of medical care exist in the delivery of health care is one thing, knowing what to do about them in a meaningful policy way is quite another. Bruce Vladeck, who has rapidly become a respected voice in health policy circles, addresses this question in this paper. Vladeck draws three conclusions, all of which reflect his belief that, given the diversity of the United States and the medical care system's capacity to generate revenues, a tightly regulated system makes the most policy sense. Vladeck, who holds a doctorate in political science from the University of Michigan and who has taught at Columbia University, concedes that—in this era of deregulation — he remains an unrepentant regulator. Vladeck, who became president of the United Hospital Fund, New York City, a year ago, was formerly an assistant vice-president of The Robert Wood Johnson Foundation. He is perhaps best known in the health policy community for managing the implementation of New ...