...Their nightmare scenario, unspoken in this article but clearly haunting it, is American healthcare. In our first BMJ Essay published this week, Arnold Relman gives his own no-holds barred account of the US system (doi:10.1136/bmj.e3052). How, he asks, does the US system manage to spend twice as much as some other countries and yet achieve, on average, much worse outcomes? His answer: "the US alone among advanced Western countries has allowed its healthcare system to become a market and its physicians to behave as if they were in business."
Pollock and colleagues offer no solution to the problem they identify. Relman does: private but non-profit multidisciplinary groups of salaried physicians, paid for by a single public plan providing universal access to comprehensive care. It sounds familiar. But he thinks the US will have to go bankrupt first.
Fiona Godlee, editor, BMJ
Cite this as: BMJ 2012;344:e3300
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