Cost control, quality begin with information at point-of-care

Controlling costs under managed care usually means making existing procedures less expensive. This approach takes too isolated a view and starts too late. Effective cost control--that maintains or improves quality--begins from a comprehensive view of the totality of the health care process. Some procedures may be unnecessary all together. Some prescription drugs may seem too expensive at first, but in the long run, they so improve patient's health, they save money. In the end, decisions about cost control revert to the classic clinical-ethical question: "Are the services about to be presented necessary, appropriate and the best choice for this particular patient?"