Introduction to the theme

Spicker introduces a set of five articles on medico-economic, ethical, and conceptual problems raised by the new Medicare prospective payment system (PPS), which bases reimbursement of hospitals on treatment of patients in disease categories known as diagnosis related groups (DRGs). The articles are by Charles E. Begley ("Prospective payment and medical ethics"); George J. Agich ("Incentives and obligations under prospective payment"); Thomas Halper ("DRGs and the idea of a just price"); Leonard M. Fleck ("DRGs: justice and the invisible rationing of health care resources"); and Edmund L. Erde ("Efficiency, ethics and indigent care: a review of the proceedings of the conference 'The all-payers DRG system: has New Jersey found an efficient and ethical way to provide indigent care?").