Resource allocation and the cost of quality.

The costs of producing quality medical care and the proper allocation of resources to assure quality are major contemporary concerns. Minimalists attempt to improve quality and lower costs through the application of the theory, "less is more." Bureaucracies make the same attempt through the denial of payments for "unnecessary" services. Governments and insurers try to "improve quality" by impeding the flow of new technology so that costs will be restricted (presumably allowing society better access to current care modalities). All impose regulations and requirements on medical practice. Each of these approaches is examined individually and substantial problems with their application in actual practice are illustrated. Genuine quality is not a cost or resource allocation problem. Quality is free.