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September 1984

Potential Impact of Newer Health Care Legislation on the Character and Quality of Cardiovascular Care: Is the Profession at Risk?

Author Affiliations

From the Department of Cardiology, Good Samaritan Hospital, and Wright State University School of Medicine, Dayton, Ohio.

Arch Intern Med. 1984;144(9):1836-1838. doi:10.1001/archinte.1984.00350210162027

The rules by which medicine is practiced have changed dramatically during the past two decades and especially in the past few years. These changes have come primarily through the efforts of government and industry to control rising medical costs.

In the 1960s, government and society at large made a pivotal decision. The decision to give unlimited medical care to most of our population. Medicare and Medicaid were introduced and private insurance became widely available. Industry responded freely to demands for more and more medical coverage, preferring fringe benefits to spiraling salaries. The end result was what economist Martin Feldstein called "a permanent excess demand for medical services of all kinds."

The cost to society has exceeded all predictions for several reasons. The tremendous explosion of medical technology and, perhaps, its inappropriate application increased not only costs but utilization.

There was unprecedented inflation, a war, and an arms race. The national

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