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May 1994

Random and Rambling Thoughts on a Lazy Sunday Afternoon: An Example of the Chaos Theory

Arch Pediatr Adolesc Med. 1994;148(5):524. doi:10.1001/archpedi.1994.02170050082016

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THE "New Health Care System" is being developed by Hillary Rodham Clinton. Is there an "Old Health Care System"? Webster's New Collegiate Dictionary defines system as "a regularly interacting or interdependent group of items forming a unified whole." It also says it may be "an organized set of doctrines, ideas, or principles usually intended to explain the arrangement or working of a systematic whole."

Health care in the United States fulfills neither definition. So what is it that the Health Care Task Force is going to do, and how are they going to measure its efficacy? Its access? Its cost? Its quality of care? Its mortality or morbidity statistics? How does one measure the effect of socioeconomic status on health? Why are the poor so unhealthy compared with the more affluent? Is it a societal problem, an individual's responsibility, or some combination of those plus other factors?

Most pediatricians probably

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