This Article  • Full text  • PDF  • Send to a friend  • Save in My Folder  • Save to citation manager  • Permissions  Citing Articles  • Contact me when this article is cited  Related Content  • Similar articles in this journal

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

The article "A 2020 Vision for American Health Care"¹ is a call to action to expand our current medical care model using the budget surplus. I agree that there is major fixing to be done. The WHO recently reported the huge amount of money the United States spent on health care, many times more than most other countries.² The WHO report also shows that the United States lags sorely in many leading indicators of health outcomes despite the large financial outlay.

To propose spending more money on a system that is already broken reminds me of the observation by Evans et al³ at the time of a nurses' strike in overbedded Los Angeles, Calif, a few years ago. They noted the paradox of being unable to spend enough money on a system that wasn't necessary in the first place. To suggest spending more money on an expensive medical care system . . . [Full Text of this Article]