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Understanding Rising Health Care Costs: Introducing a Series of Articles

Harold C. Sox, MD, Editor
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Ann Intern Med. 2005;142(10):865. doi:10.7326/0003-4819-142-10-200505170-00014
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The cost of health care is one of the most serious problems facing the United States. Health care costs are a terrible burden to federal and state governments, to employers, to employees, and to the uninsured. In some cases, the expenditures are buying real gains. The level of disability in older people is lower than it used to be (1), as is the death rate from heart disease (2). But good evidence suggests that the intensity of care varies widely and that more intense care does not substantially improve health (34). Despite growing concern that U.S. health care expenditures are hurting the economy and aren't necessarily helping patients, leaders seem paralyzed by the magnitude of the problem and the poor prospects for change. Somehow, our country seems too big, too diverse, and too much under the sway of special interests to deal with this problem.

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Chasing an illusion in controlling health care costs
Posted on May 22, 2005
Mark A. Stafford
University of Alabama Birmingham
Conflict of Interest: None Declared

In our culture's infatuation with science, we often forget that in medicine there are few, and some would argue, no absolutes. We deal in probability and relativity. Until the public, including phyisicians and the courts, learn to live comfortably with a measure of uncertainty in our diagnoses, treatments and outcomes, without fear of punitive retribution, controlling health care costs will remain an illusion.

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