Acknowledgements - 1 Containing health care costs: market competition versus a coordinated public policy. 2 Early attempts to control health care costs, 1950-1980. 3 The Reagan administration and medicare hospital payment. 4 Medicaid: State approaches to cost containment for the poor. 5 The experience of State rate-setting agencies. 6 Corporate cost containment initiatives. 7 Health maintenance organizations. 8 The effectiveness of cost containment efforts in containing health care costs, 1950-1987. 9 The impáct of cost containment on hospital care to the poor and uninsured. 10 The impact of cost containment efforts on the quality of care. 11 Major lessons from the past experience. 12 Future directions for the health care system: a long-range policy proposal.