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Abstract
The Value Problem
The United States spends more than double what any other nation spends on healthcare on a per capita basis (Squires 2011). Nearly one-fifth of our gross domestic product now is related to healthcare (NHE Fact Sheet 2011), which would not in itself be unacceptable if we could demonstrate that our investment led to a healthier population and that funds were not being wasted. However, most analyses show that the U.S. ranks poorly in relation to other industrialized nations on measures such as access to care, quality of care (which is not just about how much technology is available), timeliness of care and effectiveness of care (Schoen 2010). Furthermore, every dollar spent on healthcare is a dollar that could have been invested in other public goods such as education. There is a large body of evidence demonstrating that our healthcare system does not consistently deliver high-quality care, that medical errors are commonplace, and that a large portion of our health spending is wasted on ineffective, duplicative or otherwise unnecessary care. So, we have a significant value problem: we’re spending a lot, but we are not getting a lot for our money.
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