IOM Urges Action to Fix ‘Broken’ US Health Care System

WASHINGTON—The nation’s health care industry is broken and urgently needs reorganization and reform to fix it, a new Institute of Medicine (IOM) report asserts. As a beginning, the report proposes that Congress appropriate $1 billion over the next 3 to 5 years to begin repairing what it calls a disjointed and inefficient system.

The money would support a fund to help subsidize promising reform projects and communicate the need to alter the health care system rapidly and significantly.

"Americans should be able to count on receiving care that uses the best scientific knowledge to meet their needs, but there is strong evidence that this frequently is not the case," said William C. Richardson, president of the W.K. Kellogg Foundation, who chaired the committee that wrote the report. He said that the system is failing because it is poorly designed. For even the most common conditions, such as breast cancer and diabetes, there are very few programs that use multidisciplinary teams to provide comprehensive services to patients, he said. "For too many patients, the health care system is a maze," he commented.

Clinicians, health care organizations, and the purchasers of health services should focus on improving care for such chronic ailments as heart disease, diabetes, and asthma because they are extremely common and consume a substantial segment of health care resources.

The report noted that these diseases require long-term care by a variety of practitioners in different settings, but that physician groups, hospitals, and health care organizations are so poorly coordinated that they often provide care without having complete information about patients’ conditions, medical histories, or treatments provided elsewhere.

The panel recommended that the reform effort begin by having the Agency for Healthcare Research and Quality (AHRQ) identify 15 or more common health conditions, mostly chronic. Then the various participants in the health care system should cooperate in developing and implementing strategies and action plans to improve care for each of the conditions over a 5-year period.