The ethics and economics of high-technology medicine

The exceptional advances of modern medicine have restored to productive life many patients with previously fatal or disabling diseases, but these very successes have raised a host of troubling ethical and economic questions. Reconciling society's increasing demands on medicine with the realities of inflation, governmental regulations, changing social values, and an aging population poses knotty problems, the answers to which will not be found in pious platitudes. To expect every American to receive ultrasophisticated health care at bargain-basement prices is merely delusional. Several resolutions of the controversies have been proposed, but real cost-benefit will derive from research into disease prevention and greater personal responsibility for maintaining health. Its vocal critics notwithstanding, the American health system remains the best in the world. Our society must decide whether medicine is to remain a profession or is to operate by governmental edict, and we must be prepared to accept the consequences of our decision.