The medical care system and prevention: the need for a new paradigm

HMO Pract. 1998 Mar;12(1):5-13.


The American medical care system falls to provide effective prevention services even though some prevention services are among the most cost-effective medical procedures available. Many prevention services are routinely delivered in inefficient or ineffective ways, and new technologies may be widely and aggressively implemented despite serious doubts about their efficacy and cost-effectiveness. The barriers to effective prevention services result from conceptual limitations in our model of medical care systems, particularly the lack of a population-based perspective. A change in paradigm is needed before reforms in our health care system can improve health without bankrupting the nation.

Publication types

  • Review

MeSH terms

  • Cholesterol / blood
  • Cost-Benefit Analysis
  • Health Promotion
  • Health Status Indicators
  • Humans
  • Immunization Programs / organization & administration
  • Organizational Innovation*
  • Practice Patterns, Physicians'
  • Preventive Health Services / economics
  • Preventive Health Services / organization & administration*
  • Preventive Health Services / standards
  • Prostate-Specific Antigen / analysis
  • Quality-Adjusted Life Years
  • Smoking Cessation
  • United States


  • Cholesterol
  • Prostate-Specific Antigen