American health care is caught in a vise which has created a dire situation physician training in preventive medicine as a specialty is currently in a fiscal crisis due to the lack of training dollars medical centers are reluctant to divert their graduate medical education medicare training dollars from acute care to prevention and the . The current health system does not have a management problem it has an economics problem the looming crisis in our system has three identifiable causes the government s monopoly over funding for medical care the politically planned allocation of medical goods and services and the lack of consumer exposure to the cost of using health care. Even if the federal government were not an obstacle there are still reasons why states might not be able to craft and implement successful solutions to the challenges of health policy probably the most widely used metaphor in health policy is the balloon squeeze health care costs in one part of the system and they whoosh to another. 5 ways to solve health care by michael d tanner the issue of preexisting conditions becomes far less of a problem the governments other big health care program is medicaid like . The inability to properly measure cost and compare cost with outcomes is at the root of the incentive problem in health care and has severely retarded the shift to more effective reimbursement
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