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Health Service Use Constant

The monthly use of healthcare services by Americans has remained remarkably consistent over the past 40 years, according to the Agency for Healthcare Research and Quality. In an average month, 800 of every 1,000 Americans experience health-related symptoms; 217 visit a doctor, and eight are hospitalized.

Medical Advertising

Some drug manufacturers and healthcare providers are advertising products and services directly to consumers, even though doctors must often prescribe the products or services. Advertisers expect that consumers will confer with their doctors, who may then prescribe treatment.

Managed Care Growth

Managed care now covers the majority of Americans. Government programs, including Medicare and Medicaid, have acquired many of the characteristics of managed care plans. For example, plans make payments only for allowed procedures and at a fixed price.

Doctors' Changing Role

Managed care, and the greater scientific complexity of medicine, are changing the role of doctors subtly but fundamentally. Most notably, doctors within a managed care system have fewer treatment options, feel pressure to avoid using expensive diagnostic and treatment methods, and increasingly must follow standardized "best practices" procedures. Because of the increasing complexity of medicine, "primary care" doctors are more likely to refer patients to specialists. More doctors are also joining group practices.

Questionable Results from High Costs

The US spends a larger percentage of its GDP on healthcare than any other nation, currently over 16 percent, yet the health of Americans, on average, is no better than in many countries that spend far less. On one measurement report of healthy life expectancy, developed by WHO, the US ranks 24th. The probability of a child dying before age five is just 0.8 percent in the US, but lower in 20 other countries.