How consumer-driven health plans will affect your practice.

T U.S. health care system has a lot going for it – tremendous resources, a talented workforce and cutting-edge science and technology – yet by many accounts, it is a mess. In 2004, medical spending in this country reached a staggering $1.9 trillion and grew 7.9 percent over the previous year. Although this was the slowest growth rate since 2000, health care spending still rose faster than wages and inflation and now accounts for 16 percent of the gross domestic product, which is far more than in any other industrialized nation. These world-class costs might be excusable if they corresponded with world-class outcomes, but all too often they don’t. As employers and other payers begin to find these costs unsustainable, they are embracing new models of health care financing that give consumers more control and more responsibility. Illustrations by Simon Shaw