chapter  12
Hospitals, Doctors, and Global Budgets
WithEli Ginzberg
Pages 4

"Global budgeting” is conventional shorthand for a national system to limit the funds flowing into the health care sector. A more critical and complex challenge that the advocates of global budgeting will have to face relates to the suballocation of the total funds, first to the states and then to sectors within the states, for further distribution to hospitals, nursing homes, and physicians. The opponents of global budgeting propose as an alternative one or another version of managed competition, on the assumption that the competitive market will be able to assure the effective allocation of resources and control prices. Once the nation has introduced global budgeting, and not until then, will politicians, physicians, hospitals, and the public be able to address the second challenge: How to improve the efficiency and the effectiveness of the resources that are directed to health care and at the same time assure reasonable equity in the distribution of services.