Impasse at the crossroads: evolution or regulation

Today, the free enterprise system of health care delivery is being challenged in the United States, where availability and consumption of health services and their cost are epochal. Review of the health care delivery systems of other nations reveals failure of the system when the national medical community has been divided, when government has monopolized the system, and when fee for service has been abandoned. Government intervention in American health care has been increasingly regulatory and promises to extend regulation in the immediate future. The American medical community can respond by unifying, by reducing its contribution to health care costs, and by changing physician behavior. Consumers have the responsibility to eliminate unnecessary utilization and to become more informed buyers of health care and insurance. The fiscal intermediary has the responsibility to provide tailored insurance options that are cost-effective. As informed and unified medical community can be a formidable force in shaping the future of health care in the United States.