President's Message
The Best Health System
in the World

1. What's Wrong: A Snapshot
2. Lessons from the Scorecard
3. What's Right: A Blueprint for Change

Printable version of this article
(18 pages)

The central messages emanating from the scorecard are clear. Whether measured in dollars or human terms, we are paying an unaffordable price for our health system's lackluster performance. In order to address the system's shortcomings, we must:
A highly motivated health care workforce. Particularly in the nation's hospitals and long-term care facilities, high turnover among "front-line" workers, such as nursing home aides-a result of low wages, a lack of benefits, and stressful working conditions-puts the health and quality of life of patients and residents at serious risk. Shortages of primary care physicians, nurses, and other key health personnel further undermine health system performance.
More research on evidence-based care and innovative delivery models. While we spend nearly $2 trillion on health care, we devote just $1.5 billion to health systems research, less than $1 for every $1,000 in national health care spending.
Greater investment in information technology. Electronic information systems show considerable promise for enhancing efficiency, eliminating duplication and waste, reducing medical errors, assisting physicians, nurses, pharmacists, and other health professionals in delivering the best care, and ensuring that patients are informed, active partners in their care. The U.S. lags behind leading nations in its use of such systems.
Improved capacity to measure quality. Quality is unlikely to be improved if it cannot be measured. The current capacity of the U.S. system to measure and assess performance is fragmented and highly variable. Lack of more integrated data systems across the multiple private and public payers undermines national, state, or regional public or private efforts to assess access, quality, or efficiency of care.
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