The Transition from Planning to Markets in National Health Policy for Acute Care Hospitals: The Pittsburgh Experience
"I can finally lay to rest the Federal health planning authorities. I have sought their repeal since I assumed office. These authorities, while perhaps well-intentioned when enacted in the 1970's, have only served to insert the Federal government into a process that is best reserved to the marketplace" (U.S. Code, Congressional and Administrative News, 1986, 6410). Thus, President Reagan ended a 40-year national policy to make health care more accessible, to improve geographic distribution, to redirect resources to provide more economical services and to reduce excess capacity. 1 The departure from long-standing national policy provides an opportunity to analyze the outcome under an institutionalist law and economics analysis based upon the work of John R. Commons. This analytical tool will be described and its application demonstrated with respect to acute care hospitals in Allegheny County, Pennsylvania.