Throughout the industrialized world—from the United States to Japan, from Scandinavia to Australia—the theme of cost containment dominates the discourse on health care. This issue is the offspring of successful past efforts to ensure all patients effective medical care. While many countries have groups with special health disadvantages, the great majority of people in the industrialized nations have access to modern medical care and make ready use of it. The problem now is its cost, as aging populations, increasing in number as the result of advanced techniques that are more effective in prolonging life, place considerable strains on health care budgets.