The healthcare system in the United States rewards inefficiency, is slanted towards care for acute rather than chronic conditions, and fails to take full advantage of electronic technology. The result is that it consistently fails to provide safe, high quality medical care. It is disjointed and inefficient and urgently needs reorganisation and reform. These were the conclusions of a new report from the US Institute of Medicine, National Academy of Sciences.

The current healthcare system cannot do the job. Building on or modifying it will not work, said the institute's committee on quality of health care in its latest report, published last week.

The committee was formed in 1998 and was charged with drawing up a strategy that would lead to substantial improvement in the quality of health care over the next 10 years. The report presents general principles rather than a detailed blueprint for the building of a new system of …