US physician manpower needs. Generalists and specialists: achieving the balance.

EVEN THOUGH the United States spends more money on health care than any other country in the world, an increasing number of Americans do not have access to a physician. Their lack of access is not caused by a shortage of physicians in the United States. Rather, it is caused by the fact that they do not have health insurance, or they live in a rural area or an inner city. The glaring deficiency of the US health care system is that 15% to 20% of Americans lack health insurance, and the number of uninsured is increasing. Many of the uninsured do not receive ongoing primary care or preventive care. They receive episodic care, usually in the setting of the emergency department. With the failure of the Clinton Health Plan, correction of this major deficiency in our health care system has been put on a back burner, while all efforts