The Emergent Logic of Health Care – Article by M. Gregg Bloche

From Volume 82, Number 3 (March 2009)
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The American health care system is on a glide path toward ruin. Medical spending is rising at an unsustainable rate: it is on track to reach 30 percent of gross domestic product (“GDP”) a quarter century from now and half of GDP within seventy-five years. The number of Americans without health insurance is approaching fifty million, and surging unemployment could push this figure much higher. Most of the care that patients receive is of unproven value, and up to one hundred thousand Americans die prematurely each year from medical mistakes. So it is for good reason that health reform has returned to the top of the nation’s political agenda. A decade and a half after the collapse of President Clinton’s health reform plan, Americans are again pressing for relief from soaring costs and telling pollsters and politicians that they want medical care for all. The main difference, this time, is that the problems have grown much worse.