The restructuring of U.S. health care.

Despite highly publicized recognition in the 1970s that a health care financing crisis existed in the United States, the crisis has gone unabated. In this review of the recent health care experience, I discuss the federal and other initiatives that were taken in the 1970s to curb health care cost increases and why they failed. I then review transformations that are currently altering the health care delivery and payment system in this country. I conclude with a discussion of three possible scenarios for the U.S. health care system at the end of the century. In the absence of a grass-roots acceptance of the limitations of medical intervention, it seems likely that total outlays will continue to increase. That is, we are probably in for "more of the same."