The rising costs of health care in general and cancer care in particular have prompted increasing concern in recent years.1,2 Data from the Organisation for Economic Co-operation and Development suggest that health care expenditure as a percent of gross domestic product is not only higher in the United States than in other developed nations but is also rising at a steeper rate.3 In 2011, the United States spent a staggering 18% of gross domestic product—$2.7 trillion—on health care.4
Scott D. Halpern, M.D., Ph.D., and Allan S. Detsky, M.D., Ph.D.
Traditionally, physician training has followed the apprenticeship model: students, residents, and clinical fellows participate in delivering medical services to patients under the supervision of accredited professionals. This hierarchical system offers trainees graded responsibility, enabling them to learn their trade by performing increasingly complex functions over time and experiencing gradual reductions in supervision.
Nigel Crisp, M.A., and Lincoln Chen, M.D.
There is a global crisis of severe shortages and marked maldistribution of health professionals that is exacerbated by three great global transitions — demographic changes, epidemiologic shifts, and redistribution of the disability burden. Each of these transitions exerts a powerful force for change in health care systems, the roles of health professionals, and the design of health professional education.1-5 Every country will have to respond to these global pressures for change.
American Society of Clinical Oncology, Alexandria, VA
Corresponding author: Richard L. Schilsky,
As a leading source of cancer information worldwide, the American Society of Clinical Oncology (ASCO) values the trust of its members, the oncology community, and the public. ASCO has long been committed to transparency and independence in financial interactions with health care companies. For nearly two decades, ASCO has had policies in place that require disclosure of financial relationships by authors, presenters, and member volunteers. ASCO uses the information to manage and minimize the potential for bias and maintain the objective voice of its journals, Continuing Medical Education, clinical practice guidelines, and quality improvement programs.
Jon Kingsdale, Ph.D.
Health insurance reform was conceived as a way of improving consumer choice, and under the Affordable Care Act (ACA), the year 2014 should have provided a test of how best to do so. Instead, the flawed launch of the exchanges in most of the country will test the memory of voters and determine the electoral costs of having made it harder for Americans to buy (or keep) coverage. The first lesson from the rollout was thus entirely unintended: implementation counts.