The implications for planning are ambiguous. On the one hand, the optimal allocation under increasing returns will not be obtained under free markets… - Kenneth Arrow

Speaking very broadly, almost any human action involves choice; the external environment delimits a range of possible actions at any given moment but does not usually reduce that range to a single alternative. The formulation of a theory of human action in some sphere as a theory of choice means its presentation as a functional relation associating with each possible range of alternatives a chosen one among them.

The conflict of incentives and information is increasingly leading to a diffusion of responsibility for medical decisions. The simple picture of the physician making decisions for the patient has certainly become more complicated. Patients always had a role in choosing to seek medical advice and from whom. Their choices are becoming increasingly restricted as medical practice becomes more organized. The problems of cost control in an insured world are partly met by the increasing use of control of medical services through review by health maintenance organizations and insurance carriers.

Strictly speaking, decision theory really is concerned only with the fourth part of the division given above, that is, the determination of the computational methods for optimization. Given the determination of the other three factors―the objective function, the range of policy alternatives, and the model―the ideal picture is that someone, presumable the firm that hires the operations researcher, hands him, on a silver platter, an objective function. By talking to the engineers, or by looking into a few scientific laws, he determines the policy alternatives available and also the model.