Doremus H D
Health Care Strateg Manage. 1984 Dec;2(12):4-10.
During the past two decades, the health care industry has become an economic giant growing from 6.1% ($42.0 billion) of the gross national product in 1965 to an estimated 10.7% ($354.6 billion) in 1983. The industry is now the nation's third largest. The underlying causes of this remarkable growth include an open-ended reimbursement system, insatiable demand, and the lack of traditional market forces that encourage efficiency. Unfortunately, the nation cannot continue to allocate an increasing share of its gross national product to health care, for to do so would mean that other important sectors of the economy would experience either retarded growth or a decline in real terms. By the 2000, fundamental elements of the health care system will have undergone a major metamorphosis which hopefully will result in a more efficient and effective allocation of the health care dollar. This article will offer an overview of the changes likely to occur in sections of the health care environment of major concern to the health care planner.
在过去二十年中，医疗保健行业已成为一个经济巨头，从1965年占国民生产总值的6.1%（420亿美元）增长到1983年估计的10.7%（3546亿美元）。该行业现已成为美国第三大行业。这种显著增长的根本原因包括无限制的报销制度、无法满足的需求以及缺乏鼓励效率的传统市场力量。不幸的是，美国不能继续将其国民生产总值中越来越大的份额用于医疗保健，因为这样做将意味着经济的其他重要部门将经历增长放缓或实际下降。到2000年，医疗保健系统的基本要素将经历重大变革，有望实现医疗保健资金更高效、更有效的分配。本文将概述医疗保健规划者主要关注的医疗保健环境各部分可能发生的变化。
