However, in May, 2001 several different expert groups within health have published reports very critical of various aspects of the U.S. system, leading an article in one weekly publication on health care to state that “America’s healthcare industry is in a shambles, reeling from medical mistakes, disgruntled employees, limited resources, high costs and low confidence” (Romano, 2001). A study of 12 different U.S. communities and their health care systems reported that intensification of managed care was causing enormous turmoil, with health care organizations feeling financial pressure from the demands of employers and shareholders as well as from reimbursement cuts in government programs such as Medicare and Medicaid (Lesser & Ginsberg, 2000). In a newer report from the same study, a warning was issued that patients across the nation may be at risk due to overloaded, understaffed emergency rooms (Romano, 2001). A recent study by the Rand Corporation, a health care think tank in California, described America’s health care system as substandard and determined that only 60 percent of the chronically ill receive the medical care they actually need (Romano, 2001). An earlier Rand study reported that there are large gaps between the care people should receive and the care they did receive. Only half of those needing preventive care (to help prevent an occurrence of a health care problem or disease, rather than to treat an already existing disease or health problem), are receiving it while only two-thirds of those needing care for chronic conditions are receiving it. (Schuster et al., 1998).

Which set of statements are true and better represent the state of health care in the United States today? Is health care in the United States as good as it has ever been and among the best in the world, or is the state of health care in the United States in a shambles? As confusing as it may seem, both the positive and negative statements contain many elements of truth. Health care in the United States is far less simple than it was in 1900, and any simple, positive statement about the quality of health care is likely to be contradicted by accurate but negative facts from other sources. Some of this confusion is not new. Each decade for the last 40 years has included some discussion of a “health care crisis,” making this a most overused phrase. Current descriptions of problems and crises in the U.S. health care system abound. . .

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