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Volume 329:1672-1676 November 25, 1993 Number 22

Changes in the Delivery of Care under Comprehensive Health Care Reform
Arnold M. Epstein

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Physicians occupy a pivotal position in the health care system. Economist Victor Fuchs has called them the captain of the ship, responsible for the large majority of decisions that direct the treatment of patients and determine what happens to them1. Physicians also understand the health care system as no one else can. They know when the system works and when it fails.

The critical test of the Health Security Act will lie in the day-to-day practice of medicine. How will it work for patients? How will it work for doctors? Will reform through the Health Security Act foster better . . . [Full Text of this Article]

Structural Changes in the Delivery of Care

Interference with the Delivery of Care

Administrative Simplification

Changes in Quality Management

Medical Malpractice

Cost Containment and Physicians' Incomes

Academic Health Centers

The Need for Change

References


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