Achieving effective cost control while decreasing regulation. A response to Dr. Fein

While Dr. Rubin and Dr. Fein agree that we must achieve effective healthcare cost control while decreasing regulation, they do not agree on the means to this end. Drawing on his years as assistant secretary for planning and evaluation at the Department of Health and Human Services, Dr. Rubin presents his views on regulation, competition, PPOs and HMOs, and prospective budgets. The real issue that emerges is whether or not our society is willing to spend millions and millions of dollars for a slight prolongation of life, and at what level this type of decision should be made.