RT Book, Section A1 Mark, Daniel B. A2 Fuster, Valentin A2 Harrington, Robert A. A2 Narula, Jagat A2 Eapen, Zubin J. SR Print(0) ID 1192039012 T1 ECONOMICS AND COST-EFFECTIVENESS IN CARDIOLOGY T2 Hurst's The Heart, 14e YR 2017 FD 2017 PB McGraw-Hill Education PP New York, NY SN 9780071843249 LK accesscardiology.mhmedical.com/content.aspx?aid=1192039012 RD 2024/03/28 AB In March 2010, the US Congress passed and President Obama signed a historic new health care legislation, the Patient Protection and Affordable Care Act (PPACA). The full impact of this complex bill on medical practice and US health care expenditures will likely not be clear for many years. The passage of this legislation was preceded by a vigorous public debate on the US health care system and options for its reform. Complex arguments about the best way to organize, deliver, and pay for health care became the stuff of the daily news reports and editorials. Major participants in the health care industry and other interest groups jostled to advance their perspectives before the US Congress and the court of public opinion. One major reason for all this attention and the justification given for both supporting and resisting passage of this legislation was a widespread concern about the current and future costs of health care and tremendous uncertainty about the best way to control these costs. According to the Centers for Medicare and Medicaid Services (CMS), the United States spent 17.5% of its gross domestic product (GDP) on health care in 2014, amounting to approximately $3 trillion.1 Approximately 52% of this expenditure went for hospital care or physician/clinical services. Drug therapy accounted for another 10%. While the rate of growth in health care spending has varied in recent years, the trajectory for the national health care bill will continue to be upward for the foreseeable future. However, despite leading the world in health care spending, the United States has a system with which no one seems happy.2