ABSTRACT
This chapter examines the increased complexity of the health care system in relation to competing interest groups and changing economic circumstances. The debate on health policy proceeds alongside a growing appreciation that the value of increased medical efforts and improved technology is probably less than the public believes. The psychology of illness, and the importance that consumers give to their own medical care, make policy formulation particularly difficult. Reasonable consumers can see the logic of more efficient distribution and organization of services, more parsimonious use of laboratories and technologies, and allocating resources in some relation to expected benefits, but when sick they want the best that medical science makes possible, and these wants are reinforced under a third-party payment system. The hospital, of course, is the focal point of most attention, but it is besieged by a growing number of conflicting pressures.
