Underperformance of the healthcare system at great expense is the situation in the United States. The results are great inequity, problems with access, missed opportunities for prevention, fragmented rather than integrated care, relatively poor chronic disease care, and high expenses without commensurate improvements in health as compared with what would be expected from a well-functioning primary care system.1 Indeed, “. . . the need to manage escalating health care costs while maintaining reasonable access to care is becoming the salient challenge in US health care policy”.2
The full article is accessible to AMA members and paid subscribers. Login to read more or purchase a subscription now.
Please note: institutional and Research4Life access to the MJA is now provided through Wiley Online Library.
- The Robert Graham Center, Policy Studies in Family Medicine and Primary Care, Washington, DC, USA.
- 1. Phillips RL Jr, Starfield B. Why does a US primary care physician workforce crisis matter? Am Fam Physican 2003; 68: 1494-1505.
- 2. Mello MM, Studdert DM, Brennan TA. The pharmaceutical industry vs Medicaid-limits on state initiatives to control prescription-drug costs. N Engl J Med 2004; 305: 608-613.
- 3. Levit K, Smith C, Cowan C, et al. Health spending rebound continues in 2002. Health Affairs 2004; 23(1): 147-159.
- 4. 2004 FACTS about family practice. Table 8: Practice profile of family physicians by family practice residency completion, January 1, 2004. Available at: www.aafp.org/x763.xml (accessed Jun 20 04).
- 5. DeVoe J, Fryer GE, Hargraves L, et al. Does career dissatisfaction affect the ability of family physicians to deliver high-quality patient care? J Fam Pract 2002; 51: 223-228.
- 6. Future of Family Medicine Project Leadership Committee. Martin JC, Chairman. The future of family medicine: a collaborative project of the family medicine community. Ann Fam Med 2004; 2 Suppl: S3-S32.
- 7. Hill E. Making sense of preventive medicine coding. Fam Pract Manag 2004; 11: 49-54.
- 8. Leatherman S, Berwick D, Iles D, et al. The business case for quality: case studies and an analysis. Health Affairs 2003; 22(2): 17-30.
- 9. Galvin R. Purchasing health care: an opportunity for a public–private partnership. Health Affairs 2003; 22(2): 191-195.
- 10. Wallack SS, Tompkins CP. Realigning incentives in fee-for-service medicare. Health Affairs 2003; 22(4): 59-70.
- 11. Weil A. There’s something about Medicaid. Health Affairs 2003; 22(1): 13-30.
- 12. Dale S, Brown R, Phillips B, et al. The effects of cash and counseling on personal care services and medicaid costs in Arkansas. Health Affairs 2003; W3: 566-575.
- 13. Finkelstein EA, Flebelkorn IC, Wang G. National medical spending attributable to overweight and obesity: how much and who’s paying? Health Affairs 2003; W3: 219-226.
- 14. The Washington Primary Care Forum #33. Cosmos Club. 18 Dec 2003.
- 15. Green LA, Graham R, Frey JJ, Stephens GG, editors. Keystone III. The role of family practice in a changing health care environment: a dialogue. Washington, DC: The Robert Graham Center, American Academy of Family Physicians, 2001.