| Summary: | The U.S. health care system is broken. Overall life expectancy has improved, but the burden of chronic illness is increasing, and racial and socioeconomic disparities in mortality are widening. Almost 50 million Americans lack health insurance, and coverage for many others is inadequate. The safety and reliability of care in hospitals, surgical centers, nursing homes and physician offices is far from assured. And health care costs-already the highest in the world-are growing at a rate that poses a serious threat to patients, employers and the nation. For two decades, the Dartmouth Atlas Project has examined regional variations in the practice of medicine and in spending for health care, principally in the Medicare population. This policy brief focuses on what we have learned about the relationship between regional differences in spending and the quality of care-and the implications for efforts to reform the U.S. health care system
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