ABSTRACT
The Unites States has the most ineffective healthcare system in the developed world. Human errors abound in a system that is far too complicated for the human brain to handle. The US bonus system creates a minimal incentive for innovation and a huge incentive for fraud. In the Netherlands, legislation in 1979 enabled the minister to restrict certain technologies to certain hospitals while they were being evaluated by systematic reviews of the literature. The rationale for a proposed clinical trial must be based on a rigorous, systematic review of all previous trials with similar drugs, with meta-analysis if possible. Divisions in drug agencies that deal with harms of drugs should be separated from the divisions that approve drugs and should have their own authority, enabling them to remove drugs from the market. Drug companies should be prohibited from financing continuing medical education, as the purpose is to sell drugs and as it’s harmful.
