(Liu, 2008) This report states that the threat of litigation gets in the way of health care delivery in that is "causes providers to hide problems and engage in unnecessary procedures to avoid potential negative occurrences. If caregivers document mistakes, they are immediately exposed to litigation. Consequently, obfuscation and secrecy become the standard practice when confronted with errors. Quality issues are concealed and knowledge is suppressed, leading to the high likelihood that mistakes will be replicated." (Liu, 2008)

The answer in addressing quality issues and medical errors is a "system of health courts practice to the arbitration system utilized to address other complex issues requiring dispute resolution, such as workers' compensation, tax and patent disputes and vaccine liability, where claims against institutions are adjudicated. Health courts would administer peer reviews and independent analysis of procedural errors - differentiating between human error and negligence - and determining damages proportionate to the mistakes." (Liu, 2008) the answer is also inclusive of mandating 'best practices' in which providers are held accountable for health care delivery to the best known standard." (Liu, 2008)

VI. ECONOMIC ISSUE - FUNDING and CONSUMER PREFERENCE

The requirements in today's health care system and the challenges presented in the provision of health care and the expanding group of elderly population are complex in nature and cross disciplinary boundaries. New methods of financing health care must be designed and long-term care desperately needs new and innovative methods of long-term health care provision. There is a requirement for ongoing integration and management of both acute and long-term health care services and a need for the addition of new services to the continuum of care. Since today's consumers are more individualized and knowledgeable than the previous generation, development of health care services that are efficient and effective will necessarily require the input of this generation of aging individuals who believe in getting the most for their hard-earned money. Naturally, as new services need not be added if they are not going to positively contribute to the health care provision in terms of what the consumer requires then these services will represent ill-spent funding so much research is required in this area in establishing precisely what requirements will be presenting to the health care system in the years to come.

Health care is estimated to be $4.5 trillion by 2017 representing approximately 20% of the GDP. Chronic health care conditions and dementia will be relevant in the extremely large group of the elderly population by 2017 comprised mainly of baby boomers. This combined with a reduction in capacity of health care institutions due to staff shortages presents many challenges to the health care system. New and different methods of health care financing and new services for health care provision are necessary requirements in addressing these challenges in future health care in the United States and specifically in providing health care for the extremely large group represented by the baby boomers that will comprise the elderly population.
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