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Volume 347:1971-1975 December 12, 2002 Number 24
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Homeostasis without Reserve — The Risk of Health System Collapse

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In the early 1930s, at the height of the Depression, the great Harvard physiologist Walter Cannon, in his book The Wisdom of the Body, first outlined the theory of homeostasis, proposing that biologic systems use compensatory mechanisms to maintain stability in the face of environmental changes. Few physicians know, however, that Cannon proposed that "stability is of prime importance" for organizations and social systems as well.1

Although most observers of the health care system view the 1990s as a period of extensive instability and change, in reality the health care system, taken as a whole, exhibited remarkable homeostasis. In 1992, . . . [Full Text of this Article]

The Evidence for Homeostasis

So What Has Changed?

Deep Force 1: Steady Increases in Real Health Care Costs

Deep Force 2: Unabated Demand for Health Care Services

Deep Force 3: Dispirited Providers

Stress, Discontinuity, or Collapse?

Preventing Collapse


Related Letters:

Homeostasis without Reserve — The Risk of Health System Collapse
Sandroni S., Sandy L. G.
Extract | Full Text | PDF  
N Engl J Med 2003; 348:1410, Apr 3, 2003. Correspondence

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