delivery of health care services. One of the most recent policy interventions in this area by the federal government is a requirement for second surgical opinions for all Medicaid funded patients, before Medicaid funding for a surgical procedure is authorized.
While there is little dispute over the objective of the second surgical opinion requirement, some observers have cited problems in implementation (Tillotson, & Rosada, 1989). The problems noted range from increasing, as opposed to declining, costs for Medicaid funded surgical procedures to the placing of Medicaid patients at increased risk because of delays in the delivery of necessary services to increased abuse of the Medi caid system by some physicians.
It has been widely reported and acknowledged that the fastest growing segment of the domestic economy of the United
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