The economic market forces which are restructuring the United States' $400-billion-per-year health industry will have a profound effect on pediatric-practice in the coming decade, two prominent health care economists recently told the Executive Board.

At a planning session on child health financing held immediately before its regular January meeting, the board heard presentattions by Alatin C. Enthoven, Ph.D., the Marriner S. Eccles Professor of Public and Private Management at Stanford University's Graduate School of Business and School of Medicine; and by Paul M. Ellwood, M.D., president of InterStudy, an Excelsior, Minn., think tank on health policy.

The traditional fee-for-service health care delivery system has few built-in rewards for cost-efficiency, Dr. Enthoven told the board. He explained that the system gives third-party payers no bargaining power for cost-efficient behavior by health care providers, and assures that there will be no economic competition among physicians. It also is characterized by aninsurance system which has provided increasingly comprehensive coverage, making patients cost-unconscious.

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