Preface

• Publication year: 1991
• Citation: Vol. 14 No. 03

UNIVERSITY OF PUGET SOUND LAW REVIEWVolume 14, No. 3SPRING 1991

SYMPOSIUM

Preface

Kenneth R. Wing, Professor of Law University of Puget Sound School of Law

My first experience with a law review symposium such as this one was at the University of North Carolina in the mid-1970s. Under a grant from the Carter Administration we commissioned a series of articles around a similar theme-hospital cost containment-that were eventually published in 1980.(fn1) The articles reflected what was then the dominant version of health care policy: that current efforts to contain costs were the forerunners of a more elaborate and centralized system of public regulatory controls. Thus, several authors examined the legal problems that would be encountered under a scheme of expanded government control over resource allocation; another critiqued existing mechanisms to integrate consumer involvement in regulatory decisionmaking; and another analyzed the difficulty of administering efforts to police the quality of services in tandem with government programs that are primarily oriented towards cost reduction and budget control. But each of the articles, mirroring much of the academic and political debate of that time, adopted the underlying assumption that the future of cost containment would be built around government, and primarily federal government, regulatory strategies. Indeed, the purpose of the original grant from the Carter Administration was to provide some of the legal foundation for the federal hospital rate setting program, Carter's "9% Solution." That program had been proposed by the Administration as the interim holding action in anticipation of the more comprehensive cost controls that would be made part of the nationalized health financing scheme that Carter had envisioned as the centerpiece of his national health policy.

Even before that symposium was published, the Carter strategy had proven to be highly unpopular, thus making those articles auspiciously out-of-date. The proposal for a federal hospital rate setting scheme was soundly rejected by Congress. Anticipating the same fate, Carter's promise of national health insurance was quietly forgotten. The same political and academic debates that had so recently assumed government regulation as a foregone conclusion were suddenly giving considerable attention to a...