• Health care planners could be more effective and efficient if they used the concept of the natural history of disease and the levels of prevention to design services that intervene at the weakest link in the chain of progression of specific diseases. Instead, most focus on high-technology solutions to preventable problems. Assess the characteristics of the medical care culture that encourage the latter approach.
• Hospitals and other health care institutions, whether voluntary or for-profit, need to be financially solvent to survive growing market pressures. Describe how this “bottom line” focus has changed the nature of the US health care system.
• The insurance industry plays a huge role in the American health care system and absorbs a significant portion of the health care dollar. A single payer system, whether it is a private company or the US government, would eliminate the complex insurance paperwork burden and free substantial funds that could be diverted to support care for the under-served. Why do you believe that so much resistance to a concept used in every other developed country has continued in the U.S.?
• Include the time management Weekly Planner to show when you will make room for your school work.

Discussion Question:

The practice of medicine, long valued for individual entrepreneurship and physician control, has undergone dramatic change. Physicians now face vexing oversight of case and utilization management and loss of control over the allocation of health care dollars. Managed care organizations control health costs by arbitrarily refusing reimbursement for certain medical procedures and reducing payments for others. Since medicine is now a less attractive career option, will fewer high performing individuals choose to become physicians? What are the implications for the quality of care?