ABSTRACT
This chapter explores the evidence that the US healthcare system often does not provide quality care, and examines the solutions that have been implemented to address the issues, as well as some of the controversies the solutions have created. It examines the evidence that supports the perception that there is room for improvement in delivering high-quality care in the US. The chapter shows that international comparisons must be used with caution, as some of the differences in quality measures may not reflect differences in the healthcare systems. The chapter considers the web of relationships between health and socioeconomic factors, such as income, education, and occupational status. It examines five strategies for strengthening the system: aligning incentives via payment system design, creating organizations that provide better care coordination, focusing on wellness and preventative care, utilizing new types of providers to gain greater efficiencies, and leveraging health information technology to become more systematic in healthcare delivery and quality of care monitoring.
