It is the year of gnawing knuckles. With shifts in the medical market of unprecedented size and pace, doing nothing seems to be the worst plan of all. Hospitals must merge, doctors must form networks, employers must find managed care options, insurers must develop report cards. Listening carefully to the sounds beneath the frenzy. A fraying of purpose.
Cost control is, or course, the driving aim.
But the controlling of costs is, in fact, no aim at all. It is, rather, a const5raint on aim. You would ask me first to reflect on what I wish to buy. The question of purpose is the rock bottom issue in The State of Health Care in America, 1995. Without an answer the other components of activity sound hollow, because they are hollow.