Alternate modes of financing health care technology.

† This Keynote Lecture was delivered on 29 November 2000 during the Opening Ceremony of the 11 Congress of the Western Pacific Association of Critical Care Medicine. Alternative financing of health care delivery is one of the most vexing problems facing medicine today. Intensive care in many ways is a perfect example of the core problems facing policymakers responsible for financing health care. Intensive care is very expensive, its delivery is variable across and within countries, it is an arena into which new technologies are introduced regularly, often at further increase in cost, and these costs are only likely to continue growing as the human race ages. Inextricably linked to the financing and cost of health care is the need to consider quality. Some have argued that by improving the quality of care, costs will fall. Whether true or not, others have pointed out that to look only at costs could result in favouring policies that are very deleterious for the patient. In this presentation, I will discuss some pertinent issues fueling the current financing crisis in health care, including the concurrent problem of poor quality and errors in health care delivery, and review various techniques designed to deliver higher quality health care yet more efficiently while utilising available resources.