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Improved methods of delivering medical and dental care will have little effect until doctors and hospitals are motivated to adopt them. The most important research task is to find levers to change the system. Among the needs is an institutional framework in which nonprofit hospitals become concerned with efficiency. Consumers need tools for evaluating the service they receive, and motivation to avoid extravagance. The medical insurance system should reward quality and efficiency. The licensing system should be changed to eliminate restrictions that serve mainly to keep needed health personnel scarce. 9 pp.

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