Theme Issue on Health of the Nation

Abstract

A 232-YEAR-OLD “PATIENT” 1 HAS BEEN EXPERIENCing acute and chronic systemic health problems. Despite the concerted efforts of dedicated and superb physicians, the availability of state-of-theart medical treatments and technological advances, and trillions of dollars in annual health care expenditures, major aspects of the health, well-being, and prognosis for this complex “patient”—ie, the United States and its health care system—are, at best, less than optimal. For example, the United States ranks below several other industrialized nations in terms of several key health care indicators, such as life expectancy, infant mortality, and rates of obesity. Despite the world’s highest per capita health expenditures, the numbers of uninsured and underinsured continue to increase and are at an all-time high. Health care costs continue to escalate, threatening the long-term viability of government-based insurance systems such as Medicare and Medicaid and of some employer-based private health insurance. Moreover, the nation’s health care system is fragmented and difficult to negotiate, creating frustration for physicians and patients, as well as challenges for improving quality and efficiency in the delivery of medical care. Perhaps because these serious symptoms and signs affecting the nation’s health have continued to intensify and increase, health care has emerged as one of the leading domestic issues in the current US presidential campaign. In the past, suggested solutions have failed because they could not muster the necessary broad-based political support. While many of the current presidential candidates have (as in past presidential campaigns) put forth their plans, proposals, and promises, none of the proffered solutions, at least thus far, appears to have the degree of diagnostic precision nor the specific prescription necessary for improving the nation’s health in an effective, meaningful, and sustainable way. To focus additional attention on and continue the momentum of interest in this pressing topic, JAMA will publish a theme issue devoted to the “Health of the Nation” in October 2008. We invite authors to submit manuscripts on virtually any topic relevant to the issue of the nation’s health. High-quality original research papers that present new scientific information and solid data will receive highest priority. Potential topics include documentation of health status and understanding the health consequences and implications of inadequate care and underinsurance; evidence-based manuscripts that provide evidence for or propose rational steps toward finding solutions to improving the nation’s health care; analyses of factors influencing the composition of the nation’s health care workforce, including potential implications for improving health care delivery; rigorous econometric analyses that consider the financial ramifications of workable approaches to health system reform and systemwide economic solutions; and studies thatprovidecomparativeanalyses for improvingnationalhealth based on experience and perspectives from health systems in other countries. Systematic reviews and scholarly commentaries on these and other topics relevant to reforming health care and improving the nation’s health also will receive careful consideration. In addition, as in previous election years, we plan to invite the major presidential candidates to describe their specific plans for improving the nation’s health. Authors are encouraged to consult the Instructions for Authors for guidelines on manuscript preparation and submission. All submitted manuscripts will undergo JAMA’s usual rigorous editorial evaluation and review. Manuscripts received by June 1, 2008, will have the best chance of consideration for inclusion in the Health of the Nation theme issue of JAMA. We look forward to receiving manuscripts for this theme issue, with the hope that information in this issue will contribute to a more accurate “diagnosis,” will provide viable ideas and suggestions for effective “treatments,” and will help improve the short-term and longterm prognosis for the Health of the Nation.