The Origins of the Quality-of-Care Debate

The current concern about quality of care in the United States is deeply paradoxical in many ways. From a technical and scientific standpoint, the capabilities of the nation's health care system are extraordinary. Decades of biomedical research have culminated in new forms of technology that have greatly improved the health of Americans. Two examples (benefiting very different demographic groups) are neonatal intensive care units and new inpatient treatments for coronary artery disease. Neonatal intensive care units account for a substantial portion of the recent decline in neonatal and infant mortality rates in the United States.1 Improvements in the inpatient care . . .