[Economic aspects of medical imaging]

By tempering the amount of procedures, an alternative scenario of a reasonable expense growth can be pursued, which can assure the development and investment in new technologies, the income position of radiologists, and the financial equilibria for the National Health Insurance and radiological departments. Nomenclature modifications in 1990 and 1992 borrow partly these principles: they focus on diminishing reimbursement for outdated or overrated techniques, combining procedures and introducing consultant fees and other fixed charges. The purpose was to split reimbursement of X-rays and the procedures volume to discourage overproduction and to improve fees for the intellectual contribution of radiologists. Expenses growth in 1990 was lowered to 2.4% with substantial reductions in some subsectors. Changes in 1992 resulted even in saving 1.25 billion francs. It is concluded that the policy needs improvement. We are in favour of furthering the nomenclature modernization: tariffs should be kept closer to cost reality to inhibit influences of gain or loss perspectives and procedures volume should be reduced partly by financing with fixed charges, integrating some dispensations in consultant fees, carrying out medical evaluation by radiologists and regulating the supply of radiologists.