Quality health care in a regulated society.

T he decade that began in 1966, when Medicare and Medicaid were introduced, has been termed "The Decade of Regulation ." Health care continues to be a target of regulation today. The 2,883 health-related bills introduced into the 95th Congress represent approximately 11 percent of the total. The office of the Federal Register reports that 61,000 pages of regulations were published in 1978, compared to 20,000 in 1970, an increase of more than 300 percent. Federal and state governments enact these numerous regulations each year for social, economic, political, and other reasons, supposedly to benefit society. Although some regulations are needed, others border on the absurd, are difficult if not impossible to administer, and may be conflicting or contradictory. In my role as executive officer of a large medical center, I have realized the complexity of these regulations perhaps to a greater degree than would be apparent to many others. This ex-