Seit der Sachverständigenrat für die Konzertierte Aktion im Gesundheitswesen in seinem Jahresgutachten 2000/2001 zu dem Ergebnis kam, dass das deutsche Gesundheitswesen von einem fatalen Nebeneinander der Über-, Unter- und Fehlversorgung gekennzeichnet sei, beherrscht dieses Paradigma die gesundheitspolitische Debatte. Dabei überwog lange die Ansicht, die bestehenden ineffizienten Versorgungsstrukturen brächten vor allem eine kostspielige Über- und Fehlversorgung hervor.
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