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Cureus. 2018 May 31;10(5):e2720. doi: 10.7759/cureus.2720.

The United States Health Care System is Sick: From Adam Smith to Overspecialization.

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HMNS, The University of Queensland.


The United States (US) health care system is sick. High cost affects the nation and the people. The poor outcomes mainly impact the patients. If we do not fix it, the system will implode because of the unsustainable economic burden. The choice to shape the health care system on the "pin factory" model described by Adam Smith is the cause of the failure. The key players in the health care system are accordingly molded. Many factors tightly intertwined need to be addressed. Medical education, the role of family doctor, the overspecialization and, not least, the translation of discoveries into clinical practice are among them. The failure of the US health care system is a complex and multi-factorial issue which requires a global approach.


family doctor; healthcare cost; healthcare system; nih; overspecialization

Conflict of interest statement

The authors have declared that no competing interests exist.

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