title: 2000 and beyond: a perspective.
abstract: There once was a beautiful city in which the people were prosperous and, for the most part, happy. However, there was a very high road that perched precariously along the rim of a deep canyon. A number of people slipped and fell over the edge and were killed. Others were injured in the fall, some very seriously. The medical establishment of this fine city developed a superb emergency response team, built and staffed several trauma centers, and designed efficient rehabilitation facilities. As the population of the city grew, proportionately more people fell off the cliff. The medical establishment gained more experience and devised ways to save people who previously would have died. However, certain people thought of another possibility: Why not erect a fence at the top of the cliff? When they voiced the idea, many were quite disturbed. The ambulance drivers weren't keen on the idea, neither were the ambulance manufacturers, nor were those who made their living in the hospital industry. The medical authorities explained that the problem was far more complex than people realized, that building a fence was far from practical, and that health was far too important to be left in the hands of people who were not experts. "Leave it to us," they said, "for soon we will genetically engineer people who do not bruise or become injured by such falls." So, no fences were built and, as time passed, this city found itself spending more money on medical care than anyone in the history of the world. As the price of treating people kept rising, many people could not afford medical care....
authors.forename: L L
authors.initials: LL
authors.lastname: Curtin
mesh_terms: D006801:Humans; D024802:Nurse's Role; D011634:Public Health / Q000592:standards / Q000639:trends*; D011787:Quality of Health Care; D011788:Quality of Life; D014481:United States