Medical care in the United States cost about $400 billion in 1985. It is big business and the subject of great controversy. During the past decade the hospital, as part of the medical system, has become the focus of much of the controversy. Attention has centered on how to control hospital costs, the large-scale activities of for-profit corporations in providing medical care, the extent to which alternative payment systems for Medicare might alter hospitals' behavior, and how the nation can provide needed hospital services for the 35 million people who do not have hospital insurance of any kind. Increasing concern has emerged about the extent to which the intense businesslike orientation of hospitals of all kinds has undermined their role as community institutions providing a much-needed public service. Although many other serious issues exist, these have engendered the most discussion.
This study is concerned primarily with comparing the behavior of for-profit, public, and voluntary hospitals.