Author: Elisabeth Rosenthal
Publisher: Penguin
ISBN: 0698407180
Category : Medical
Languages : en
Pages : 434
Book Description
A New York Times bestseller/Washington Post Notable Book of 2017/NPR Best Books of 2017/Wall Street Journal Best Books of 2017 "This book will serve as the definitive guide to the past and future of health care in America.”—Siddhartha Mukherjee, Pulitzer Prize-winning author of The Emperor of All Maladies and The Gene At a moment of drastic political upheaval, An American Sickness is a shocking investigation into our dysfunctional healthcare system - and offers practical solutions to its myriad problems. In these troubled times, perhaps no institution has unraveled more quickly and more completely than American medicine. In only a few decades, the medical system has been overrun by organizations seeking to exploit for profit the trust that vulnerable and sick Americans place in their healthcare. Our politicians have proven themselves either unwilling or incapable of reining in the increasingly outrageous costs faced by patients, and market-based solutions only seem to funnel larger and larger sums of our money into the hands of corporations. Impossibly high insurance premiums and inexplicably large bills have become facts of life; fatalism has set in. Very quickly Americans have been made to accept paying more for less. How did things get so bad so fast? Breaking down this monolithic business into the individual industries—the hospitals, doctors, insurance companies, and drug manufacturers—that together constitute our healthcare system, Rosenthal exposes the recent evolution of American medicine as never before. How did healthcare, the caring endeavor, become healthcare, the highly profitable industry? Hospital systems, which are managed by business executives, behave like predatory lenders, hounding patients and seizing their homes. Research charities are in bed with big pharmaceutical companies, which surreptitiously profit from the donations made by working people. Patients receive bills in code, from entrepreneurial doctors they never even saw. The system is in tatters, but we can fight back. Dr. Elisabeth Rosenthal doesn't just explain the symptoms, she diagnoses and treats the disease itself. In clear and practical terms, she spells out exactly how to decode medical doublespeak, avoid the pitfalls of the pharmaceuticals racket, and get the care you and your family deserve. She takes you inside the doctor-patient relationship and to hospital C-suites, explaining step-by-step the workings of a system badly lacking transparency. This is about what we can do, as individual patients, both to navigate the maze that is American healthcare and also to demand far-reaching reform. An American Sickness is the frontline defense against a healthcare system that no longer has our well-being at heart.
An American Sickness
Author: Elisabeth Rosenthal
Publisher: Penguin
ISBN: 0698407180
Category : Medical
Languages : en
Pages : 434
Book Description
A New York Times bestseller/Washington Post Notable Book of 2017/NPR Best Books of 2017/Wall Street Journal Best Books of 2017 "This book will serve as the definitive guide to the past and future of health care in America.”—Siddhartha Mukherjee, Pulitzer Prize-winning author of The Emperor of All Maladies and The Gene At a moment of drastic political upheaval, An American Sickness is a shocking investigation into our dysfunctional healthcare system - and offers practical solutions to its myriad problems. In these troubled times, perhaps no institution has unraveled more quickly and more completely than American medicine. In only a few decades, the medical system has been overrun by organizations seeking to exploit for profit the trust that vulnerable and sick Americans place in their healthcare. Our politicians have proven themselves either unwilling or incapable of reining in the increasingly outrageous costs faced by patients, and market-based solutions only seem to funnel larger and larger sums of our money into the hands of corporations. Impossibly high insurance premiums and inexplicably large bills have become facts of life; fatalism has set in. Very quickly Americans have been made to accept paying more for less. How did things get so bad so fast? Breaking down this monolithic business into the individual industries—the hospitals, doctors, insurance companies, and drug manufacturers—that together constitute our healthcare system, Rosenthal exposes the recent evolution of American medicine as never before. How did healthcare, the caring endeavor, become healthcare, the highly profitable industry? Hospital systems, which are managed by business executives, behave like predatory lenders, hounding patients and seizing their homes. Research charities are in bed with big pharmaceutical companies, which surreptitiously profit from the donations made by working people. Patients receive bills in code, from entrepreneurial doctors they never even saw. The system is in tatters, but we can fight back. Dr. Elisabeth Rosenthal doesn't just explain the symptoms, she diagnoses and treats the disease itself. In clear and practical terms, she spells out exactly how to decode medical doublespeak, avoid the pitfalls of the pharmaceuticals racket, and get the care you and your family deserve. She takes you inside the doctor-patient relationship and to hospital C-suites, explaining step-by-step the workings of a system badly lacking transparency. This is about what we can do, as individual patients, both to navigate the maze that is American healthcare and also to demand far-reaching reform. An American Sickness is the frontline defense against a healthcare system that no longer has our well-being at heart.
Publisher: Penguin
ISBN: 0698407180
Category : Medical
Languages : en
Pages : 434
Book Description
A New York Times bestseller/Washington Post Notable Book of 2017/NPR Best Books of 2017/Wall Street Journal Best Books of 2017 "This book will serve as the definitive guide to the past and future of health care in America.”—Siddhartha Mukherjee, Pulitzer Prize-winning author of The Emperor of All Maladies and The Gene At a moment of drastic political upheaval, An American Sickness is a shocking investigation into our dysfunctional healthcare system - and offers practical solutions to its myriad problems. In these troubled times, perhaps no institution has unraveled more quickly and more completely than American medicine. In only a few decades, the medical system has been overrun by organizations seeking to exploit for profit the trust that vulnerable and sick Americans place in their healthcare. Our politicians have proven themselves either unwilling or incapable of reining in the increasingly outrageous costs faced by patients, and market-based solutions only seem to funnel larger and larger sums of our money into the hands of corporations. Impossibly high insurance premiums and inexplicably large bills have become facts of life; fatalism has set in. Very quickly Americans have been made to accept paying more for less. How did things get so bad so fast? Breaking down this monolithic business into the individual industries—the hospitals, doctors, insurance companies, and drug manufacturers—that together constitute our healthcare system, Rosenthal exposes the recent evolution of American medicine as never before. How did healthcare, the caring endeavor, become healthcare, the highly profitable industry? Hospital systems, which are managed by business executives, behave like predatory lenders, hounding patients and seizing their homes. Research charities are in bed with big pharmaceutical companies, which surreptitiously profit from the donations made by working people. Patients receive bills in code, from entrepreneurial doctors they never even saw. The system is in tatters, but we can fight back. Dr. Elisabeth Rosenthal doesn't just explain the symptoms, she diagnoses and treats the disease itself. In clear and practical terms, she spells out exactly how to decode medical doublespeak, avoid the pitfalls of the pharmaceuticals racket, and get the care you and your family deserve. She takes you inside the doctor-patient relationship and to hospital C-suites, explaining step-by-step the workings of a system badly lacking transparency. This is about what we can do, as individual patients, both to navigate the maze that is American healthcare and also to demand far-reaching reform. An American Sickness is the frontline defense against a healthcare system that no longer has our well-being at heart.
Access to Health Care in America
Author: Institute of Medicine
Publisher: National Academies Press
ISBN: 0309047420
Category : Medical
Languages : en
Pages : 240
Book Description
Americans are accustomed to anecdotal evidence of the health care crisis. Yet, personal or local stories do not provide a comprehensive nationwide picture of our access to health care. Now, this book offers the long-awaited health equivalent of national economic indicators. This useful volume defines a set of national objectives and identifies indicatorsâ€"measures of utilization and outcomeâ€"that can "sense" when and where problems occur in accessing specific health care services. Using the indicators, the committee presents significant conclusions about the situation today, examining the relationships between access to care and factors such as income, race, ethnic origin, and location. The committee offers recommendations to federal, state, and local agencies for improving data collection and monitoring. This highly readable and well-organized volume will be essential for policymakers, public health officials, insurance companies, hospitals, physicians and nurses, and interested individuals.
Publisher: National Academies Press
ISBN: 0309047420
Category : Medical
Languages : en
Pages : 240
Book Description
Americans are accustomed to anecdotal evidence of the health care crisis. Yet, personal or local stories do not provide a comprehensive nationwide picture of our access to health care. Now, this book offers the long-awaited health equivalent of national economic indicators. This useful volume defines a set of national objectives and identifies indicatorsâ€"measures of utilization and outcomeâ€"that can "sense" when and where problems occur in accessing specific health care services. Using the indicators, the committee presents significant conclusions about the situation today, examining the relationships between access to care and factors such as income, race, ethnic origin, and location. The committee offers recommendations to federal, state, and local agencies for improving data collection and monitoring. This highly readable and well-organized volume will be essential for policymakers, public health officials, insurance companies, hospitals, physicians and nurses, and interested individuals.
Best Care at Lower Cost
Author: Institute of Medicine
Publisher: National Academies Press
ISBN: 0309282810
Category : Medical
Languages : en
Pages : 437
Book Description
America's health care system has become too complex and costly to continue business as usual. Best Care at Lower Cost explains that inefficiencies, an overwhelming amount of data, and other economic and quality barriers hinder progress in improving health and threaten the nation's economic stability and global competitiveness. According to this report, the knowledge and tools exist to put the health system on the right course to achieve continuous improvement and better quality care at a lower cost. The costs of the system's current inefficiency underscore the urgent need for a systemwide transformation. About 30 percent of health spending in 2009-roughly $750 billion-was wasted on unnecessary services, excessive administrative costs, fraud, and other problems. Moreover, inefficiencies cause needless suffering. By one estimate, roughly 75,000 deaths might have been averted in 2005 if every state had delivered care at the quality level of the best performing state. This report states that the way health care providers currently train, practice, and learn new information cannot keep pace with the flood of research discoveries and technological advances. About 75 million Americans have more than one chronic condition, requiring coordination among multiple specialists and therapies, which can increase the potential for miscommunication, misdiagnosis, potentially conflicting interventions, and dangerous drug interactions. Best Care at Lower Cost emphasizes that a better use of data is a critical element of a continuously improving health system, such as mobile technologies and electronic health records that offer significant potential to capture and share health data better. In order for this to occur, the National Coordinator for Health Information Technology, IT developers, and standard-setting organizations should ensure that these systems are robust and interoperable. Clinicians and care organizations should fully adopt these technologies, and patients should be encouraged to use tools, such as personal health information portals, to actively engage in their care. This book is a call to action that will guide health care providers; administrators; caregivers; policy makers; health professionals; federal, state, and local government agencies; private and public health organizations; and educational institutions.
Publisher: National Academies Press
ISBN: 0309282810
Category : Medical
Languages : en
Pages : 437
Book Description
America's health care system has become too complex and costly to continue business as usual. Best Care at Lower Cost explains that inefficiencies, an overwhelming amount of data, and other economic and quality barriers hinder progress in improving health and threaten the nation's economic stability and global competitiveness. According to this report, the knowledge and tools exist to put the health system on the right course to achieve continuous improvement and better quality care at a lower cost. The costs of the system's current inefficiency underscore the urgent need for a systemwide transformation. About 30 percent of health spending in 2009-roughly $750 billion-was wasted on unnecessary services, excessive administrative costs, fraud, and other problems. Moreover, inefficiencies cause needless suffering. By one estimate, roughly 75,000 deaths might have been averted in 2005 if every state had delivered care at the quality level of the best performing state. This report states that the way health care providers currently train, practice, and learn new information cannot keep pace with the flood of research discoveries and technological advances. About 75 million Americans have more than one chronic condition, requiring coordination among multiple specialists and therapies, which can increase the potential for miscommunication, misdiagnosis, potentially conflicting interventions, and dangerous drug interactions. Best Care at Lower Cost emphasizes that a better use of data is a critical element of a continuously improving health system, such as mobile technologies and electronic health records that offer significant potential to capture and share health data better. In order for this to occur, the National Coordinator for Health Information Technology, IT developers, and standard-setting organizations should ensure that these systems are robust and interoperable. Clinicians and care organizations should fully adopt these technologies, and patients should be encouraged to use tools, such as personal health information portals, to actively engage in their care. This book is a call to action that will guide health care providers; administrators; caregivers; policy makers; health professionals; federal, state, and local government agencies; private and public health organizations; and educational institutions.
The American Health Care Paradox
Author: Elizabeth Bradley
Publisher: Public Affairs
ISBN: 1610392094
Category : Political Science
Languages : en
Pages : 274
Book Description
Considers why U.S. society is believed to be less healthy in spite of disproportionate spending on health care, identifying a lack of social services, outdated care allocations, and a resistance to government programs as the problem.
Publisher: Public Affairs
ISBN: 1610392094
Category : Political Science
Languages : en
Pages : 274
Book Description
Considers why U.S. society is believed to be less healthy in spite of disproportionate spending on health care, identifying a lack of social services, outdated care allocations, and a resistance to government programs as the problem.
Crossing the Quality Chasm
Author: Institute of Medicine
Publisher: National Academies Press
ISBN: 0309132967
Category : Medical
Languages : en
Pages : 359
Book Description
Second in a series of publications from the Institute of Medicine's Quality of Health Care in America project Today's health care providers have more research findings and more technology available to them than ever before. Yet recent reports have raised serious doubts about the quality of health care in America. Crossing the Quality Chasm makes an urgent call for fundamental change to close the quality gap. This book recommends a sweeping redesign of the American health care system and provides overarching principles for specific direction for policymakers, health care leaders, clinicians, regulators, purchasers, and others. In this comprehensive volume the committee offers: A set of performance expectations for the 21st century health care system. A set of 10 new rules to guide patient-clinician relationships. A suggested organizing framework to better align the incentives inherent in payment and accountability with improvements in quality. Key steps to promote evidence-based practice and strengthen clinical information systems. Analyzing health care organizations as complex systems, Crossing the Quality Chasm also documents the causes of the quality gap, identifies current practices that impede quality care, and explores how systems approaches can be used to implement change.
Publisher: National Academies Press
ISBN: 0309132967
Category : Medical
Languages : en
Pages : 359
Book Description
Second in a series of publications from the Institute of Medicine's Quality of Health Care in America project Today's health care providers have more research findings and more technology available to them than ever before. Yet recent reports have raised serious doubts about the quality of health care in America. Crossing the Quality Chasm makes an urgent call for fundamental change to close the quality gap. This book recommends a sweeping redesign of the American health care system and provides overarching principles for specific direction for policymakers, health care leaders, clinicians, regulators, purchasers, and others. In this comprehensive volume the committee offers: A set of performance expectations for the 21st century health care system. A set of 10 new rules to guide patient-clinician relationships. A suggested organizing framework to better align the incentives inherent in payment and accountability with improvements in quality. Key steps to promote evidence-based practice and strengthen clinical information systems. Analyzing health care organizations as complex systems, Crossing the Quality Chasm also documents the causes of the quality gap, identifies current practices that impede quality care, and explores how systems approaches can be used to implement change.
Essentials of the U.S. Health Care System
Author: Leiyu Shi
Publisher: Jones & Bartlett Learning
ISBN: 1284175170
Category : Business & Economics
Languages : en
Pages : 390
Book Description
Essentials of the U.S. Health Care System, Fifth Edition is a clear and concise distillation of the major topics covered in the best-selling Delivering Health Care in America by the same authors. Designed for undergraduate and graduate students in programs across the health disciplines, Essentials of the U.S. Health Care System is a reader-friendly, well organized resource that covers the major characteristics, foundations, and future of the U.S. health care system. The text clarifies the complexities of health care organization and finance and presents a solid overview of how the various components fit together.
Publisher: Jones & Bartlett Learning
ISBN: 1284175170
Category : Business & Economics
Languages : en
Pages : 390
Book Description
Essentials of the U.S. Health Care System, Fifth Edition is a clear and concise distillation of the major topics covered in the best-selling Delivering Health Care in America by the same authors. Designed for undergraduate and graduate students in programs across the health disciplines, Essentials of the U.S. Health Care System is a reader-friendly, well organized resource that covers the major characteristics, foundations, and future of the U.S. health care system. The text clarifies the complexities of health care organization and finance and presents a solid overview of how the various components fit together.
The Price We Pay
Author: Marty Makary
Publisher: Bloomsbury Publishing USA
ISBN: 1635574129
Category : Health & Fitness
Languages : en
Pages : 305
Book Description
New York Times bestseller Business Book of the Year--Association of Business Journalists From the New York Times bestselling author comes an eye-opening, urgent look at America's broken health care system--and the people who are saving it--now with a new Afterword by the author. "A must-read for every American." --Steve Forbes, editor-in-chief, FORBES One in five Americans now has medical debt in collections and rising health care costs today threaten every small business in America. Dr. Makary, one of the nation's leading health care experts, travels across America and details why health care has become a bubble. Drawing from on-the-ground stories, his research, and his own experience, The Price We Pay paints a vivid picture of the business of medicine and its elusive money games in need of a serious shake-up. Dr. Makary shows how so much of health care spending goes to things that have nothing to do with health and what you can do about it. Dr. Makary challenges the medical establishment to remember medicine's noble heritage of caring for people when they are vulnerable. The Price We Pay offers a road map for everyday Americans and business leaders to get a better deal on their health care, and profiles the disruptors who are innovating medical care. The movement to restore medicine to its mission, Makary argues, is alive and well--a mission that can rebuild the public trust and save our country from the crushing cost of health care.
Publisher: Bloomsbury Publishing USA
ISBN: 1635574129
Category : Health & Fitness
Languages : en
Pages : 305
Book Description
New York Times bestseller Business Book of the Year--Association of Business Journalists From the New York Times bestselling author comes an eye-opening, urgent look at America's broken health care system--and the people who are saving it--now with a new Afterword by the author. "A must-read for every American." --Steve Forbes, editor-in-chief, FORBES One in five Americans now has medical debt in collections and rising health care costs today threaten every small business in America. Dr. Makary, one of the nation's leading health care experts, travels across America and details why health care has become a bubble. Drawing from on-the-ground stories, his research, and his own experience, The Price We Pay paints a vivid picture of the business of medicine and its elusive money games in need of a serious shake-up. Dr. Makary shows how so much of health care spending goes to things that have nothing to do with health and what you can do about it. Dr. Makary challenges the medical establishment to remember medicine's noble heritage of caring for people when they are vulnerable. The Price We Pay offers a road map for everyday Americans and business leaders to get a better deal on their health care, and profiles the disruptors who are innovating medical care. The movement to restore medicine to its mission, Makary argues, is alive and well--a mission that can rebuild the public trust and save our country from the crushing cost of health care.
Delivering Health Care in America
Author: Leiyu Shi
Publisher: Jones & Bartlett Publishers
ISBN: 1284037754
Category : Business & Economics
Languages : en
Pages : 677
Book Description
Delivering Health Care in America, Sixth Edition is the most current and comprehensive overview of the basic structures and operations of the U.S. health system--from its historical origins and resources, to its individual services, cost, and quality. Using a unique "systems" approach, the text brings together an extraordinary breadth of information into a highly accessible, easy-to-read resource that clarifies the complexities of health care organization and finance while presenting a solid overview of how the various components fit together.While the book maintains its basic structure and layout, the Sixth Edition is nonetheless the most substantive revision ever of this unique text. Because of its far-reaching scope, different aspects of the Affordable Care Act (ACA) are woven throughout all 14 chapters. The reader will find a gradual unfolding of this complex and cumbersome law so it can be slowly digested. Additionally, as U.S. health care can no longer remain isolated from globalization, the authors have added new global perspectives, which the readers will encounter in several chapters.Key Features:- Comprehensive coverage of the ACA and its impact on each aspect of the U.S. health care system woven throughout the book- New "ACA Takeaway" section in each chapter as well as a new Topical Reference Guide to the ACA at the front of the book- Updated tables and figures, current research findings, data from the 2010 census, updates on Healthy People 2020, and more- Detailed coverage of the U.S. health care system in straightforward, reader-friendly language that is appropriate for graduate and undergraduate courses alike
Publisher: Jones & Bartlett Publishers
ISBN: 1284037754
Category : Business & Economics
Languages : en
Pages : 677
Book Description
Delivering Health Care in America, Sixth Edition is the most current and comprehensive overview of the basic structures and operations of the U.S. health system--from its historical origins and resources, to its individual services, cost, and quality. Using a unique "systems" approach, the text brings together an extraordinary breadth of information into a highly accessible, easy-to-read resource that clarifies the complexities of health care organization and finance while presenting a solid overview of how the various components fit together.While the book maintains its basic structure and layout, the Sixth Edition is nonetheless the most substantive revision ever of this unique text. Because of its far-reaching scope, different aspects of the Affordable Care Act (ACA) are woven throughout all 14 chapters. The reader will find a gradual unfolding of this complex and cumbersome law so it can be slowly digested. Additionally, as U.S. health care can no longer remain isolated from globalization, the authors have added new global perspectives, which the readers will encounter in several chapters.Key Features:- Comprehensive coverage of the ACA and its impact on each aspect of the U.S. health care system woven throughout the book- New "ACA Takeaway" section in each chapter as well as a new Topical Reference Guide to the ACA at the front of the book- Updated tables and figures, current research findings, data from the 2010 census, updates on Healthy People 2020, and more- Detailed coverage of the U.S. health care system in straightforward, reader-friendly language that is appropriate for graduate and undergraduate courses alike
Health Care in America
Author: John C. Burnham
Publisher: JHU Press
ISBN: 1421416093
Category : Medical
Languages : en
Pages : 438
Book Description
A comprehensive history of sickness, health, and medicine in America from Colonial times to the present. In Health Care in America, historian John C. Burnham describes changes over four centuries of medicine and public health in America. Beginning with seventeenth-century concerns over personal and neighborhood illnesses, Burnham concludes with the arrival of a new epoch in American medicine and health care at the turn of the twenty-first century. From the 1600s through the 1990s, Americans turned to a variety of healers, practices, and institutions in their efforts to prevent and survive epidemics of smallpox, yellow fever, cholera, influenza, polio, and AIDS. Health care workers in all periods attended births and deaths and cared for people who had injuries, disabilities, and chronic diseases. Drawing on primary sources, classic scholarship, and a vast body of recent literature in the history of medicine and public health, Burnham finds that traditional healing, care, and medicine dominated the United States until the late nineteenth century, when antiseptic/aseptic surgery and germ theory initiated an intellectual, social, and technical transformation. He divides the age of modern medicine into several eras: physiological medicine (1910s–1930s), antibiotics (1930s–1950s), technology (1950s–1960s), environmental medicine (1970s–1980s), and, beginning around 1990, genetic medicine. The cumulating developments in each era led to today's radically altered doctor-patient relationship and the insistent questions that swirl around the financial cost of health care. Burnham's sweeping narrative makes sense of medical practice, medical research, and human frailties and foibles, opening the door to a new understanding of our current concerns.
Publisher: JHU Press
ISBN: 1421416093
Category : Medical
Languages : en
Pages : 438
Book Description
A comprehensive history of sickness, health, and medicine in America from Colonial times to the present. In Health Care in America, historian John C. Burnham describes changes over four centuries of medicine and public health in America. Beginning with seventeenth-century concerns over personal and neighborhood illnesses, Burnham concludes with the arrival of a new epoch in American medicine and health care at the turn of the twenty-first century. From the 1600s through the 1990s, Americans turned to a variety of healers, practices, and institutions in their efforts to prevent and survive epidemics of smallpox, yellow fever, cholera, influenza, polio, and AIDS. Health care workers in all periods attended births and deaths and cared for people who had injuries, disabilities, and chronic diseases. Drawing on primary sources, classic scholarship, and a vast body of recent literature in the history of medicine and public health, Burnham finds that traditional healing, care, and medicine dominated the United States until the late nineteenth century, when antiseptic/aseptic surgery and germ theory initiated an intellectual, social, and technical transformation. He divides the age of modern medicine into several eras: physiological medicine (1910s–1930s), antibiotics (1930s–1950s), technology (1950s–1960s), environmental medicine (1970s–1980s), and, beginning around 1990, genetic medicine. The cumulating developments in each era led to today's radically altered doctor-patient relationship and the insistent questions that swirl around the financial cost of health care. Burnham's sweeping narrative makes sense of medical practice, medical research, and human frailties and foibles, opening the door to a new understanding of our current concerns.
Health Care for Some
Author: Beatrix Hoffman
Publisher: University of Chicago Press
ISBN: 0226348032
Category : Health & Fitness
Languages : en
Pages : 357
Book Description
The 2010 Affordable Care Act is a sweeping reform to the US health care system. Hoffman offers an engaging and in-depth look at America's long tradition of unequal access to health care. She argues that two main features have characterized the US health system: a refusal to adopt a right to care and a particularly American type of rationing. Unlike rationing in most countries, which is intended to keep costs down, rationing in the United States has actually led to increased costs, resulting in the most expensive health care system in the world.
Publisher: University of Chicago Press
ISBN: 0226348032
Category : Health & Fitness
Languages : en
Pages : 357
Book Description
The 2010 Affordable Care Act is a sweeping reform to the US health care system. Hoffman offers an engaging and in-depth look at America's long tradition of unequal access to health care. She argues that two main features have characterized the US health system: a refusal to adopt a right to care and a particularly American type of rationing. Unlike rationing in most countries, which is intended to keep costs down, rationing in the United States has actually led to increased costs, resulting in the most expensive health care system in the world.