Some of the tough decisions required by a national health plan.

The goals of providing coverage for everyone in the United States and controlling the growth in national health expenditures require difficult decisions about what medical services to provide. Currently accepted practices vary enormously in the amount of health they produce for a given expenditure. Studies of the health effects of several major interventions in relation to their costs--Pap smears, mammography, coronary care units, bypass surgery, and cholesterol reduction--indicate the kinds of choices to be made.