To the Editor.—
Blendon et al (1981; 245:1843) described economic projections that indicate that funding for health care in the United States may stop increasing at its historic rate in the 1980s. This is important information that the profession ignores at its peril. I would like to suggest, however, that the title "An Era of Stress for Health Institutions" is not completely appropriate, since it presupposes that stress is an inevitable companion of change. The reality is that for institutions, as for individuals, stress relates to inability to accept or cope with change.Blendon et al are not predicting an absolute reduction in national income but only a reduction in the rate of growth. This will be no disaster for a country as rich as ours but it will compel a long-overdue reassessment of health care priorities. As Medalie1 has recently observed: "Just as economic conditions dictate that the individual
Gillette RD. Future Funding for Medical Care. JAMA. 1982;247(3):303–304. doi:10.1001/jama.1982.03320280025011
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