ABSTRACT
This chapter focuses on the quality-of-care gap, which is also an affordability issue, although more opaque. Evaluating these two issues show that true value and pay-for-performance are somewhere in the future. These numbers mean that these other 36 developed countries in the OECD throughout the world on average spend half of the percentage of their GDP on healthcare than the United States does. One might argue that the UnitedStates healthcare system delivers a higher quality of care, but as we pointed out in the Introduction, that is not the case. On the other hand, there are other systems that were concerned about revenue and more focused on margins. Because physician retention always plays an important role in decisions at the health system level, these systems found creative ways to balance revenue and margin so that both the system and physicians could benefit.
