Paradigm Shifts Health care in the U.S. has undergone dramatic changes during the past three years. A new world of health care is continually re-forming, and changes seem to occur almost on a daily basis. Many of the health care changes that have occurred since the summer of 1994 will probably continue, despite the fact that a growing body of data indicates that many current trends are having a negative impact on the quality of care. Most of these changes will be based primarily on economic rather than consumer considerations. Primary care will be emphasized, though in practice it will be carried out within significant economic and structural constraints.
Nurses can work closely with consumers to find creative solutions to health system problems.
Nurses continue to strive for a sound, caring system that focuses on health promotion and illness prevention. We need a health care system that is truly comprehensive, community-based, culturally competent, continuous, collaborative, and coordinated. In order to answer this question, we need to look at several critical variables. In the near future, at least, care will continue to be delivered in all settings. In the system we envision, there will be much more health education.