Author Affiliations: Division of Geriatrics, David Geffen School of Medicine at UCLA, Los Angeles, California (Dr Reuben); and American Board of Internal Medicine, Philadelphia, Pennsylvania (Dr Cassel).
Although there are varying opinions about the quality of health care in the United States, there is consensus that it costs too much. Even if the Patient Protection and Affordable Care Act saves some money, the proliferation of technology and the aging US population are projected to bankrupt the Medicare Part A Trust fund by 2024.1 Unless a dramatic and unlikely shift occurs in public opinion toward increasing the percentage of gross domestic product devoted to health care (17.3% in 2009),2 the amount the United States can spend on health care is finite.
Reuben DB, Cassel CK. Physician Stewardship of Health Care in an Era of Finite Resources. JAMA. 2011;306(4):430–431. doi:10.1001/jama.2011.999
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