title: The US health care system: on a road to nowhere?
abstract: This article reviews the current state and future prospects of the health care system in the United States. The 1990s were a decade of reform and change in US medical care, with the debate over the Clinton plan for universal insurance and, after its defeat, the spread of managed care. In particular, managed care had a profound impact on the delivery of medical services, transforming traditional insurance arrangements. However, after all of the changes, the United States appears to be no closer to solving the problems that have characterized its health care system for the past 3 decades. Over 40 million Americans lack health insurance, universal coverage is nowhere in sight, and medical care costs are rising again after a period of moderation. It is doubtful that incremental health reforms will significantly ameliorate these problems.
authors.affiliation: Department of Social Medicine, School of Medicine, University of North Carolina at Chapel Hill, 27599-7240, USA. oberland@med.unc.edu
authors.forename: Jonathan
authors.initials: J
authors.lastname: Oberlander
mesh_terms: D003695:Delivery of Health Care / Q000191:economics / Q000639:trends*; D017048:Health Care Costs / Q000639:trends; D018166:Health Care Reform; D005102:Health Expenditures / Q000706:statistics & numerical data / Q000639:trends; D006297:Health Services Accessibility / Q000191:economics; D006801:Humans; D007250:Inflation, Economic; D008329:Managed Care Programs / Q000191:economics / Q000639:trends; D017057:Medically Uninsured / Q000706:statistics & numerical data; D011057:Politics; D011787:Quality of Health Care; D014481:United States; D019472:Universal Health Insurance
keywords: Health Care and Public Health