Access without Appropriateness: Chicken Little in Charge?

Abstract

Health policy makers in Canada have swung between the twin poles of ensuring access and controlling costs. Recently, access has dominated. Reconciling these opposing ideals, rather than alternating between them, requires adding the concept of appropriateness, and recognizing that rapid access to unneeded care may do more harm than good. Several examples are given of resources wasted (and side effects endured) through inappropriate use, and a few modest suggestions for improvement are made.