ABSTRACT
This chapter explores various strategies for restraining costs and spending. During the decades of the 1970s, the 1980s, and the 1990s, the federal government tried both regulatory and competitive strategies to contain health costs. Similarly, state governments and the private sector have undertaken many initiatives in an attempt to contain healthcare costs. National Health Planning and Resource Development Act of 1974 provided an institutional framework for healthcare planning. It replaced three previous federal programs: Comprehensive Health Planning, the Regional Medical Program, and the Hill-Burton Hospital Construction Program. One way of addressing rising healthcare costs is rationing. The major concept behind rationing is that there are limits to what people can expect and afford in the way of healthcare. All countries engage in some form of rationing. In the United States, the major example of rationing is in organ transplantation. There are many more people who need new lungs, kidneys, hearts, and so forth than there are available organs.
