Access and affordability underscore 2002's health care conundrums.
Add to this a severe nursing shortage affecting quality of care-another cost driver-and the year is pockmarked by a series of crises, real and contrived.
This year's winners: the HMOs, hospitals, insurance companies, large pharmaceutical firms and nurses.
The losers: most consumers, obstetrics and other medical specialists, the poor and unemployed, and state Medicaid budgets.
Add to this at least 44 million uninsured Americans whose only access to health care remains a county hospital's emergency room.
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"If you have a stronger [physician] disciplinary system, then you can reduce malpractice," said Jackson Williams, legislative counsel for the Washington, D.C.-based consumer advocacy group Public Citizen.
Public Citizen this year added disciplined Florida doctors to its Web site: www.questionabledoctors.org. Williams said 6 percent of the state's physicians account for more than 45 percent of all medical malpractice.
Researcher J. Robert Hunter of the Center for Justice and Democracy in New York said medical malpractice premiums during the last decade are linked to the bond market and are not caused by claims paid.
"Average payouts have stayed virtually flat for the last decade," Hunter said.
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