10. Defining the Desired Outcome

“Common sense is in medicine the master workman.”

Peter Latham

As we’ve learned, our American healthcare machine was never actually planned in advance. Instead it evolved over time through a combination of tradition, politics, regulation, and rational response to (sometimes perverse) economic incentives. One drawback to this type of evolution is that the resulting system was never actually designed with a specific end result in mind. One can generalize by saying that our healthcare system is supposed to provide medical and preventive health services, but this says nothing about the expected cost, quality, level of accessibility, or a host of other factors. It’s as if we’ve built a vehicle with the general ...

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