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Health Planning as a Regulatory Strategy: A Discussion of its History and Current Uses

Federally mandated health planning is one of the most significant responses to the cost crisis of American medicine. Portrayed as an objective and rational mechanism of determining the future, planning is a socially acceptable means of exerting third-party control over a sector of the economy long able to escape meaningful controls on its growth and development. However, far from being the neutral science which it is heralded to be, the planning process serves the interests that are able to control its use. Health planning agencies must be studied in the context of the current emphasis on cost containment and reorganization of health services. Supported and enfranchised largely by major third-party payors, planning smooths the implementation of changes in the health sector. Despite its progressive potential, planning serves the interests of these third-party payors by masking their attempts to control the future development of the health system.