The United States has the distinction of having some of the best medical care of any technologically advanced country. We have many of the best hospitals and doctors in the world. The research pipeline is full of significant new therapeutic advances, with revolutionary genetic-based therapies.
U.S. Health policy has been directed by marketplace forces that have created powerful and sometimes perverse incentives in medicine: Health insurance companies that use every available means to avoid insuring sick people; "manage care" programs that really only manage cost. Doctors who are provided insensitive to provide less medical care, and pharmaceutical companies that develop powerful and expensive new drugs priced beyond the reach of many of the elderly and chronically ill who need them most.
Facing such a powerful and chaotic forces, physicians tend to focus narrowly on what they are most comfortable with, taking care of individuals patients and conducting academic investigations. Many doctors consider economic too arcane for them to grasp and therefore do not even try. Consequently, when presented with economic arguments and evidence they are often unable to discriminate the legitimate from fallacious. More importantly, they are ill equipped to defend their patients' interests in the crucible of cost containment that characterizes the modern manages care era.
In recent years, the medical problems and health care of women have received increasing attention. There are poorly understood differences between men and women, both in morbidity and mortality and in the expression of diseases. Many research studies of diseases prevention and pathophysiology have included only male subjects; most illnesses that can affect both sexes have not been as well studied in women. It also appears that women receive different care than men for certain common health problems. Finally, and increasing number of women are seeking health care in multidisciplinary women's health units that combine the expertise of gynecology, psychiatry, and internal medicine or family medicine.