William R. Hazzard, MD
Hazzard WR. 2001: An American Health Care Odyssey. Ann Intern Med. 1997;126:658-659. doi: 10.7326/0003-4819-126-8-199704150-00014
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Published: Ann Intern Med. 1997;126(8):658-659.
It is 2001, the new century has dawned, and the dust is settling from the great American health care revolution of the 1990s.
Six huge health care systems have survived to serve all but the fringe markets in remote rural areas: the United, American, Triangle, Northwest, Transcontinental, and U.S. health systems appear to be reasonably stable after the “merger mania” of the past 5 years. All but Transcontinental and U.S. were profitable in 2000 (these two lost more than $10 billion each, but none of the “big four” seems anxious to take over such losers with their high contract labor costs for physicians and nurses). Each system has established operational hubs in the major urban areas, huge tertiary-quaternary health centers to which patients are efficiently shuttled when their needs cannot be met in the offices of their local primary care physicians or regional primary or secondary health care centers. (Hospitals as they were known in the 20th century have virtually disappeared from all but the major cities, and those that remain have become largely critical care institutions.)
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Print ISSN: 0003-4819 | Online ISSN: 1539-3704
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