ABMT (autologous bone marrow transplantation): a microcosm of the U.S. health care system.

The continuing controversy over appropriate utilization of high-dose chemotherapy (HCDT)-autologous bone marrow transplantation (ABMT) in the treatment of cancer epitomizes the debate in this country over increasing expenditures for the application of health care technology. The debate includes all imaginable constituencies--patients, physicians, hospitals, payers, employers, lawyers, economists, and the media. The issue is fascinating, as it continually presents new twists and turns. Additionally, the way in which the HCDT-ABMT controversy is resolved (or not resolved) will presage the manner in which similar issues are addressed in the 1990s.