chapter  19
Physicians and Health Care Reform
WithEli Ginzberg
Pages 6

The expansion of the physician supply in the 1960s and 1970s was undertaken with little attention directed to the costs of enlarging the educational infrastructure and even less to the significant financial consequences for the health care system resulting from the large-scale expansion of the physician supply. One reason to expect a reduced inflow of new dollars into the health care sector is the president’s program presented to Congress on February 17, 1993 in which he stressed interdependence between financial reforms and the early introduction of universal health care coverage. In the face of dollar constraints and universal coverage, the American people will be under increasing pressure to confront the implications of overt rather than sub-rosa rationing. A more controlled and constrained financial health care environment will underpin the continuing shift of treatment to ambulatory-care settings that will be reflected sooner or later in a significant decline in the number of acutecare hospitals.