The medical profession has made great strides in improving the science of health care. The report card on the management of health care is less glorious. The drastic increases over the past decades in the cost of health care in the United States and Europe justify the latter claim. As the (now former) U.S. Comptroller General David M. Walker recently said, "unless we fix our health care system--in both the public and private sectors--rising health care costs will have severe, adverse consequences for the federal budget as well as the U.S. economy in the future." Similar dire projections can be made for Europe. (http://www.gao.gov/highlights/d071155sphigh.pdf) Some of these cost increases can obviously be attributed to the use of more advanced health care methods; today we can do a lot more than we could 50 years ago. This obviously costs money. However, another significant part of the cost increases can be attributed to health care organizations generally lagging behind in terms of implementing modern management principles. Health care organizations are rife with waste and inefficiencies. The problem with health care is therefore not the science of health care. It is with the management of health care. Unless we get better at managing health care, the benefits of the advances in the science of health care will be offset by inefficiencies in management. In fact, the marvels of modern health care science may soon only be affordable by a small minority of the population and may need to be rationed in some form or another for the rest.
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