The hospital of the year 2000: three scenarios

The topic for the 1991 Duke Forum, The 27th Annual Duke Forum on Health and Hospital Affairs, is "The Hospital of the Year 2000: Three Scenarios." The organizers, B. Jon Jaeger and myself, selected it because we believed in the fall of 1990 that no one could predict the direction that national health policy might take over the next decade. There are many forces with a stake in national health policy, and the major providers of health care--hospitals and doctors--are only two of them. Moreover, most of those forces, as will appear from the discussion below, have conflicting motives, and no national health policy is likely to emerge until there is a broad compromise, which brings most of those conflicting motives to some sort of consensus. We began with two assumptions. First, sufficient attention is being given elsewhere to what a national health policy ought to be. The AMA has a "Health Policy Agenda for the American People." The AHA is working on one. The Business Roundtable is looking at the matter. The AFL-CIO has given it attention for a number of years, and they took another look at it in Florida in February 1991. The National Leadership Commission on Health Care, now the National Leadership Coalition on Healthcare Reform, is working on a plan; so is the Health Care Leadership Council in Washington. The Pepper Commission has published its report. Other congressional groups and the Department of Health and Human Services are examining national health policy. (ABSTRACT TRUNCATED AT 250 WORDS)