Commentary |

The Perfect Storm of Overutilization

Ezekiel J. Emanuel, MD, PhD; Victor R. Fuchs, PhD
JAMA. 2008;299(23):2789-2791. doi:10.1001/jama.299.23.2789.
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“A perfect storm” occurs when a confluence of many factors or events—no one of which alone is particularly devastating—creates a catastrophic force. Such confluence is rare and devastating. Over time and through disconnected events, US health care has evolved into a “perfect storm” that drives overutilization and increases the cost of health care.

Corresponding Author: Ezekiel J. Emanuel, MD, PhD, Department of Bioethics, Bldg 10, Room 1C118, National Institutes of Health, Bethesda, MD 20892-1156 (eemanuel@nih.gov).

Financial Disclosures: None reported.

Funding/Support: Funding was provided by the Robert Wood Johnson Foundation and Blue Shield of California Foundation, neither of which had any control over the content of this article.

Disclaimer: The views expressed are those of the authors and do not represent the policies or opinions of the Department of Health and Human Services, the National Institutes of Health, or the US Public Health Service.

Additional Contributions: We thank Alan Werthehimer, PhD, for crucial comments on the manuscript and Colleen Denny, BS, for research assistance and manuscript review.

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