This article contrasts the prevailing model for assessing and improving medical care - the quality of care paradigm - with an alternative approach - the patient accountability paradigm. The first approach is technocratic: it measures and promotes the quality of medical care through technical and...

Since the late 1960s the U.S. has attempted to develop a strategy for controlling the rate of growth of health care spending. During the 1970s this strategy relied heavily on various forms of regulation. Some regulatory programs were partially successful in moderating spending increases, but...