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Roger W. Bush, MD

JAMA. 2007;297:871-874.

	Since this article does not have an abstract, we have provided the first 150 words of the full text and any section headings.

An epidemic of waste blights the US health care delivery system. Despite a huge dedication of resources to health care in the United States, the medical system does not deliver safe, effective, efficient, patient-centered, timely, and equitable care as recommended by the Institute of Medicine.¹

Specifically, the US health care system is not safe: 50 000 to 100 000 or more lives are lost each year because of medical error,² and 42% of respondents to a public survey reported experience with poorly coordinated, inefficient, or unsafe care.³

The system is not effective: 45% of recommended care is not provided, without regard to presence or type of insurance payment,⁴ and Medicare and Medicaid, which pay for about half of the compensated care in this country, do not significantly reward higher-quality care outcomes or clinicians.

The system is not efficient: three fourths of adults believe the US health care system . . . [Full Text of this Article]

Macrosystem Interventions

Waste of Overproduction

Waste of Time on Hand (Waiting)

Waste of Processing

Waste of Movement

Waste of Making Defective Products

Author Affiliation: Virginia Mason Medical Center, Seattle, Wash.

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