Free Care, Cholestyramine, and Health Policy

Over the past decade the efficacy and cost of medical interventions have been subject to increasing scrutiny with quantitative techniques, such as the randomized controlled trial and cost-effectiveness analysis. Such studies provide invaluable guidance for the clinician choosing from a limited range of options in caring for an individual patient. However, in the field of health policy myriad competing programs, services, institutions, and interests must be weighed. Unfortunately, quantitative methods are virtually always used to compare two, or at most a few, alternative strategies. Since the relative cost effectiveness of an intervention may appear radically different depending on the alternative . . .