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LAST SPRING when Dr James Thompson asked me to talk about surgical research in the capitated system, I told them it was going to be a very short speech because there is little role for traditional bench research. There are no dollars available to cross-subsidize the traditional types of surgical research that we are familiar with. I do have some information about where the dollars are and where the dollars go in a capitated system. Let me take a cynical view of the driving force for change in our health delivery system and say that the emphasis on change is not because of any driving social issue, it is because the cost of health care became unaffordable to business and government. From the purchaser's perspective of health care, they want to know where their dollars are going and do not want to spend it on "nonessential research."
I think that