Amid the myriad social transformations, corporate reorganizations,and policy innovations that have shaken the U.S. health caresystem, one great, puzzling constant endures. For roughly 40years, health care professionals, policymakers, politicians,and the public have concurred that the system is careening towardcollapse because it is indefensible and unsustainable, a studyin crisis and chaos. This forecast appeared soon after Medicareand Medicaid were enacted and has never retreated. Such disquietingcontinuity amid change raises an intriguing question: If theconsensus is so incontestable, why has the system not alreadycollapsed? Perhaps pondering this question can yield insightsinto . . . [Full Text of this Article]
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Dr. Brown is a professor in the Department of Health Policy and Management, Mailman School of Public Health, Columbia University, New York.
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