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Robert H. Brook, MD, ScD

JAMA. 2009;302(13):1465-1466.

	Since this article does not have an abstract, we have provided the first 150 words of the full text and any section headings.

Successful health care reform may provide virtually all individuals in the United States an adequate health insurance package. However, the need to increase value for health care dollars will extend far beyond the current policy window. Achieving that goal will require disruptive innovation in the health care system.

Disruption occurs when the expectations of individuals and the services provided are so vastly different that linear change is no longer likely.¹ For example, disruption occurred in naval warfare when reliance on battleships was replaced by aircraft carriers,² and in medicine when anesthesia and vaccines were introduced. Could similar kinds of successful disruption happen in the delivery of health care? There are 8 potential disruptions that could increase the value of health care.

First, the planet earth is no longer a stable environment, and its future, and that of the world's population, depends on how well it . . . [Full Text of this Article]

Author Affiliation: RAND Corporation, Santa Monica, California; and David Geffen School of Medicine and School of Public Health, University of California, Los Angeles.

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