Leading With Grace: Building an Accountable Team

Patient Safety: Grantmakers Join The Effort To Reduce Medical Errors

Financial Toxicity: A Barrier to Achieving Health Equity in Cancer Care

Our website uses cookies to enhance your experience. By continuing to use our site, or clicking "Continue," you are agreeing to our Cookie Policy | Continue JAMA HomeNew OnlineCurrent IssueFor Authors Publications JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry (1919-1959) Podcasts Clinical Reviews Editors' Summary Medical News Author Interviews More JN Learning / CMESubscribeJobsInstitutions / LibrariansReprints & Permissions Terms of Use | Privacy Policy | Accessibility Statement 2023 American Medical Association. All Rights Reserved Search All JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Forum Archive JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry Input Search Term Sign In Individual Sign In Sign inCreate an Account Access through your institution Sign In Purchase Options: Buy this article Rent this article Subscribe to the JAMA journal

Clinical Decision Support Tools

Article| October 2021 Future Challenges in Health Care: Health Policy, Health Care Financing, Access, and Clinical Care Delivery Lee A. Fleisher, MD Lee A. Fleisher, MD Search for other works by this author on: This Site PubMed Google Scholar ASA Monitor October 2021, Vol. 85, 5–7. https://doi.org/10.1097/01.ASM.0000795140.87972.ba Views Icon Views Article contents Figures & tables Video Audio Supplementary Data Peer Review Share Icon Share Twitter LinkedIn Cite Icon Cite Get Permissions Search Site Citation Lee A. Fleisher; Future Challenges in Health Care: Health Policy, Health Care Financing, Access, and Clinical Care Delivery. ASA Monitor 2021; 85:5–7 doi: https://doi.org/10.1097/01.ASM.0000795140.87972.ba Download citation file: Ris (Zotero) Reference Manager EasyBib Bookends Mendeley Papers EndNote RefWorks BibTex toolbar search Search Dropdown Menu nav search search input Search input auto suggest search filter All ContentAll PublicationsASA Monitor Search Advanced Search Topics: delivery of health care, health care financing, health policy, pandemics Since assuming my role at Centers for Medicare and Medicaid Services (CMS), I have learned how important it is for every specialty to engage with the organization to advance the “value-based” approach to care, improve quality and safety, and ensure equitable access. Based on this perspective, let me identify some key issues related to the future of health care, health policy, financing, and quality that will impact anesthesia practices over the next decade. A number of recent events, including the COVID pandemic and Black Lives Matter movement have raised awareness of health inequities for marginalized populations in this country and, as a result, have altered the course of health care delivery and health care policy. There is now clear direction from the federal government that ensuring high-quality health care for all is a priority. While the focus has increased considerably, the passage of the Patient Protection and Affordable Care Act... You do not currently have access to this content.

HEALTH CARE IN AMERICA: A HISTORY John C. Burnham Baltimore: Johns Hopkins University Press, 2015, 616 pp., $34.95 (paperback), $65.00 (hardcover).There is a broad general consensus that if we were starting with a blank slate and designing a health care system or enterprise for the United States today, the finished product likely would bear only very limited resemblance to the jumbled patchwork in evidence currently. Of course, though, we do not have the freedom to work with a tabula rasa and instead function as creatures who are both informed and empowered, on one hand, and bound, on the other, by our history. Our history, depending on one's perspective, either properly restrains us from making abrupt, radical changes or improperly prevents us from making needed, rational changes. In either event, knowing something about our history is necessary to understand why the present American health care system-for better or worse-looks like it does.Health Care in America: A History tells one version of this story, from the perspective of Ohio State University historian John C. Burnham. This volume not only details the evolution of medical science but also explains changes in how that medical science has been provided to patients and how providers have been paid for what they provide. This book is a scholarly accomplishment, written for serious students of medical history and health policy, of nearly 500 pages of text, many fascinating pictures and other graphics, 88 pages composed of more than a thousand endnotes, and a 16-page topical index.The 400-year time span covered is 1607 (the date of the first permanent European settlement in the New World) through the first decade of the 21st century. To support the author's central theme, he traces the progression of health care in the United States chronologically through the epochs of deference to tradition (1607-1880s) into modernization (1880s-1980s), characterized as the process of organizational and technological innovation, and finally into a post-1980s epoch characterized by a significant shiftin the physician-patient relationship.Out of this rich historical rendition, the reader may draw many lessons, some obvious but others perhaps unexpected. One lesson is that the current consumer information age (exemplified, e.g., by medical information on the Internet, direct-to-consumer advertising of medical products and services for real and industry-created diseases and defects, and the marketing of home testing kits) is a direct descendant of the earliest days of health care delivery in the United States when, for instance, doctors wrote books and articles for the lay public and competitively marketed their services directly to patients. A second lesson is that issues pertaining to the method, source, and amount of provider payment for services rendered (such as hidden cross subsidies for hospitals) are timeless and ongoing. Similarly, concerns about health care access and affordability, with accompanying problems relating to health disparities, have been a constant challenge since the earliest days of American medicine. Many of yesterday's gripes and fears about our health care system sound distinctly familiar today. In the realm of the physician-patient relationship, present critics ought to note with irony the complaints widely voiced 60 years ago about medical practice becoming too high tech at the expense of high touch, with physicians functioning more as coordinators of care plans rather than as direct one-on-one healers. …

Improving Patient Outcomes by Standardizing Care

A World with Fewer People with Diabetes Noncommunicable Diseases

views and personal experiences of people who have especially contributed to the evolution of ideas in the Journal's field of interest.

Rationale, considerations, and goals for atrial fibrillation centers of excellence: A Heart Rhythm Society perspective

Point: Adherence to Early Goal-Directed Therapy: Does It Really Matter? Yes. After a Decade, the Scientific Proof Speaks for Itself

The Affordable Care Act 10 Years In: What Nursing Leaders Should Know

Hospital Volume as a Quality Standard in Lung Cancer Surgery: An Unfinished Debate

2019 AATS/ACC/ASE/SCAI/STS expert consensus systems of care document: A proposal to optimize care for patients with valvular heart disease: A joint report of the American Association for Thoracic Surgery, American College of Cardiology, American Society of Echocardiography, Society for Cardiovascular Angiography and Interventions, and Society of Thoracic Surgeons

Training teams and leaders to reduce resuscitation errors and improve patient outcome