The implication, of course, is that many of our complex procedures can likely be done for less, just as it has been shown that herniorrhaphy, arthroscopy, laparoscopic cholecystectomy and many other procedures can be day cases, allowing beds to be closed without a reduction in patient service or volume and with comparable outcomes. What Canada does not need is the insertion of the managed care approach to cost cutting. We are still a liberal profession with the ability to deliver high-quality surgical care with a minimum of interference from administrators. We are not harassed daily about bed use, admission criteria, resource use, length of stay and so on. To preserve this situation, we surgeons must be prepared to be a part of the process and to be at the table, not with opinions but with data for decisions.
Economic evaluation is complex.
Where there are obvious questions, let us pose them and find the answers. Methods for the economic evaluation of health care programmes . Guidelines for economic evaluation of pharmaceuticals.