Today's preoccupation with cost shifting and cost reduction undermines physicians and patients. Instead, health care reform must focus on improving health and health care value for patients. We propose a strategy for reform that is market based but physician led. Physician leadership is essential. Improving the value of health care is something only medical teams can do. The right kind of compe...

This article describes and analyzes the U.S. health care legislation of 2010 by asking how far it was designed to move the U.S. system in the direction of practices in all other rich democracies. The enacted U.S. reform could be described, extremely roughly, as Japanese pooling with Swiss and American problems at American prices. Its policies are distinctive, yet nevertheless somewhat similar t...

The wide-ranging and significant disciplines representing allied health constitute the largest and one of the most rapidly growing health care workforces in North Carolina. With anticipated increases in patients' access to care, allied health professionals will need to call on their full scope of practice as part of a comprehensive health care team.

Equity must be the basis of primary health care if reform is to deliver the outcomes we all want.

Japan is undergoing a set of health care reforms aimed at cutting rising health care costs and increasing the efficiency of health care delivery. This empirical study used a large-scale community survey on 15,302 elderly people 65 years and older (56.0% women) conducted in seven municipalities in 2006, to reveal clear-cut evidence of barriers to necessary care. The reasons for not getting healt...

n announcing his health reform plan on September 22, 1993, President Bill Clinton spoke of six overarching principles: securi ty , savings, qual i ty , implicity, choice, and responsibility. You can be sure that all these key words have tested well in polling and focus groups. Throughout the coming months, political language will be critical in shaping the debate. Since healthcare reform is suc...