One Miracle, Many Doubts

A feat of heart surgery sharpens the debate over benefits and costs

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Among all the scientific anxieties, however, Prince|ton Economics Professor Uwe Reinhardt takes a determinedly cheerful view of the prospects. "Where is the crisis?" he says. "I have yet to see any real signs of it." Reinhardt predicts that healthcare costs could grow from the present 10.8% of G.N.P. to 12% or 13% before public opposition became serious.

"Americans will get disillusioned with defense spending long before they are disillusioned about spending money for health care."

If any such disillusionment does come, he believes, the solution is to cut back not on advanced research but on overused routines: hysterectomies, annual X rays, marginally useful laboratory tests.

The Government is already following a similar line of attack for Medicare patients by reimbursing hospitals at fixed rates for many medical procedures.

How high a price for modern medicine is too high a price? There is, as usual, no clear answer. The problem itself reflects a paradox best stated by French Novelist André Malraux: "A human life is worth nothing, but nothing is worth a human life."

—By Otto Friedrich.

Reported by Barbara B. Dolan/Louisville and Dick Thompson/San Francisco

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