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The Fragmentation of U.S. Health CareCauses and Solutions$
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Einer Elhauge

Print publication date: 2010

Print ISBN-13: 9780195390131

Published to Oxford Scholarship Online: May 2010

DOI: 10.1093/acprof:oso/9780195390131.001.0001

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The U.S. Health Care System

The U.S. Health Care System

A Product of American History and Values

(p.323) 14 The U.S. Health Care System
The Fragmentation of U.S. Health Care

David W. Johnson

Nancy M. Kane

Oxford University Press

The U.S. health care system reflects deep-rooted preferences for individualism, health crisis management, faith in markets, competition, and strong community involvement at the expense of solidarity, prevention of illness, strong government, collaboration, and public accountability. As a result it has the most technologically advanced health care that money can buy, a strong for-profit sector, and unmatched philanthropic support, while consuming a record percentage of our economy, and generating huge disparities in access to health resources and health outcomes. This chapter argues that health reformers must accommodate this value system, not confront it head-on, while looking for opportunities to encourage a slow cultural shift that recognizes the need for collaboration, collective action, accountability, and trust in government. Failure to address our values will contribute to a decline in America's global competitiveness and our national standard of living.

Keywords:   history, ideology, resource allocation, disparities

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