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I expect the Congress to respond favorably to this report. The role and responsibility of the Congress at this point is clear. First, we must articulate clear objectives and priorities for quality and quality assurance in the Medicare program and lay out a long-range strategy for that achievement. Second, we must provide adequate resources to implement that strategy. In this era of cost containment, there is a serious risk of underfunding the administration of the program generally and quality assurance, in particular. This would be a serious mistake. Here, as in so many things, we will get what we pay for. Third, we must hold parties accountable much more than we have in the past for carrying out quality assurance provisions properly and for providing quality care throughout the program.

Those are some of the thoughts I have about what is going on in our system. I appreciate what you have done in focusing on quality in our Medicare system. You have done a great work here, and I am happy to be a part of this challenging product.


Institute of Medicine. Medicare: A Strategy for Quality Assurance. Volumes I and II. Lohr, K.N., ed. Washington, D.C.: National Academy Press, 1990.

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