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Published online before print October 29, 2008, doi:10.1212/01.wnl.0000336647.02564.59)
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 Volume 71, Number 23, December 2, 2008
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NEUROLOGY 2008;71:1907-1913
© 2008 American Academy of Neurology
Special Article

Invited Article: The US health care system

Part 1: Our current system

M. R. Nuwer, MD, PhD, G. J. Esper, MD, P. D. Donofrio, MD, J. P. Szaflarski, MD, PhD, G. L. Barkley, MD and T. R. Swift, MD

From the Department of Neurology (M.R.N.), UCLA School of Medicine, Los Angeles, CA; Department of Neurology (G.J.E.), Emory University School of Medicine, Atlanta, GA; Department of Neurology (P.D.D.), Vanderbilt University School of Medicine, Nashville, TN; Department of Neurology (J.P.S.), University of Cincinnati Academic Health Center, OH; Department of Neurology (G.L.B.), Henry Ford Hospital, Detroit, MI; and Department of Neurology (T.R.S.), Medical College of Georgia, Augusta.

Address correspondence and reprint requests to Dr. Marc R. Nuwer, UCLA Department of Neurology, Reed Neurological Research Center, 710 Westwood Plaza, Room 1-190, Los Angeles, CA 90095 MRN{at}UCLA.edu

The US health care crisis is of great concern to American neurologists. The United States has the world’s most expensive health care system yet one-sixth of Americans are uninsured. The cost and volume of procedures is expanding, while reimbursement for office visits is declining. Pharmaceutical costs, durable goods, and home health care are growing disproportionately to other services. Carriers spend more for their own administration and profit than on payments to physicians. This first article on the US health care system identifies problems and proposes solutions, many of which are championed by the American Academy of Neurology through its legislative and regulatory committees.

GLOSSARY: AAN = American Academy of Neurology; ACP = American College of Physicians; AMA = American Medical Association; CF = Conversion Factor; CMS = Center for Medicare and Medicaid Services; E/M = evaluation and management; EBM = evidence-based medicine; EHR = electronic health records; ERISA = Employee Retirement Income Security Act; FEHBP = Federal Employees Health Benefits Program; HSA = health care savings account; MEI = Medicare Economic Index; MFS = Medicare Fee Schedule; RUC = Relative Value Update Committee; RVU = relative value unit; SGR = Sustainable Growth Rate.

Supplemental data at www.neurology.org

See page 1914

e-Pub ahead of print on October 29, 2008, at www.neurology.org.

References e1 through e7 are available as supplemental data on the Neurology® Web site at www.neurology.org.

Opinions expressed here are those of the authors, not of any organization.

Disclosure: The authors report no disclosures.

Received January 31, 2008. Accepted in final form September 5, 2008.


Related Article

Invited Article: The US health care system: Part 2: Proposals for improvement and comparison to other systems
M. R. Nuwer, G. L. Barkley, G. J. Esper, P. D. Donofrio, J. P. Szaflarski, and T. R. Swift
Neurology 2008 71: 1914-1920. [Abstract] [Full Text] [PDF]



This article has been cited by other articles:


Home page
 NeurologyHome page
R. L. Albin, M.R. Nuwer, G.J. Esper, G.L. Barkley, J. Szaflarski, P.D. Donofrio, and T.R. Swift
THE US HEALTH CARE SYSTEM: PART 1: OUR CURRENT SYSTEM
Neurology, August 18, 2009; 73(7): 571 - 571.
[Full Text] [PDF]

Correspondence:

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Invited Article: The US health care system: Part 1: Our current system
Roger L. Albin
Neurology Online, 6 Feb 2009 [Full text]
Reply from the authors
Marc R. Nuwer, et al.
Neurology Online, 6 Feb 2009 [Full text]

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