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May 19, 1993

American Health Care System Management ObjectivesThe Aura of Inevitability Becomes Incarnate

JAMA. 1993;269(19):2554-2555. doi:10.1001/jama.1993.03500190098045

It is the most difficult and complicated set of challenges that the United States has faced since the Great Depression; to some it seems the moral equivalent of World War II; it will last longer, be more expensive, and stands a chance of being more divisive than the Vietnam War; it intimately involves every inhabitant of our country; it holds hostage the future of what many consider history's greatest profession; it may well determine the success or failure of a president and a federal administration. It is American health care system reform in 1993.

We've come such a long way since JAMA began its series "Caring for the Poor" in December 1987. Much of our world changed its attitude when in May 1991, invoking the reformist spirit of Abraham Lincoln, JAMA and our nine specialty journals published literally hundreds of pages on national health care reform.1,2 For the first