The political economy of U.S. primary care.
Compelling evidence suggests that the United States lags behind other developed nations in the health of its population and the performance of its health care system, partly as a result of a decades-long decline in primary care. This paper outlines the political, economic, policy, and institutional factors behind this decline. A large-scale, multifaceted effort--a new Charter for Primary Care--is required to overcome these forces. There are grounds for optimism for the success of this effort, which is essential to achieving health outcomes and health system performance comparable to those of other industrialized nations.
Sandy
Lewis G
LG
UnitedHealth Group in Minnetonka, Minnesota, USA. lewis_g_sandy@uhc.com
Bodenheimer
Thomas
T
Pawlson
L Gregory
LG
Starfield
Barbara
B
D000046:Academic Medical Centers / Q000266:history; D004501:Education, Medical; D006291:Health Policy; D006304:Health Status; D006666:History of Medicine; D049673:History, 20th Century; D006801:Humans; D008511:Medicine; D011057:Politics; D011320:Primary Health Care / Q000266:history / Q000592:standards; D011787:Quality of Health Care; D014481:United States