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This Viewpoint discusses how medical innovation often does not reach vulnerable populations, a lack that results in disparities in morbidity and mortality globally. [ABSTRACT FROM AUTHOR]

This Viewpoint from the president of the National Academy of Medicine looks back at the academy's accomplishments and looks forward to the possibilities it hopes to achieve to better medicine and society. [ABSTRACT FROM AUTHOR]

Importance: Recent discussion has focused on questions related to the repeal and replacement of portions of the Affordable Care Act (ACA). However, issues central to the future of health and health care in the United States transcend the ACA provisions receiving the greatest attention. Initiatives directed to certain strategic and infrastructure priorities are vital to achieve better health at lower cost.Objectives: To review the most salient health challenges and opportunities facing the United States, to identify practical and achievable priorities essential to health progress, and to present policy initiatives critical to the nation's health and fiscal integrity.Evidence Review: Qualitative synthesis of 19 National Academy of Medicine-commissioned white papers, with supplemental review and analysis of publicly available data and published research findings.Findings: The US health system faces major challenges. Health care costs remain high at $3.2 trillion spent annually, of which an estimated 30% is related to waste, inefficiencies, and excessive prices; health disparities are persistent and worsening; and the health and financial burdens of chronic illness and disability are straining families and communities. Concurrently, promising opportunities and knowledge to achieve change exist. Across the 19 discussion papers examined, 8 crosscutting policy directions were identified as vital to the nation's health and fiscal future, including 4 action priorities and 4 essential infrastructure needs. The action priorities-pay for value, empower people, activate communities, and connect care-recurred across the articles as direct and strategic opportunities to advance a more efficient, equitable, and patient- and community-focused health system. The essential infrastructure needs-measure what matters most, modernize skills, accelerate real-world evidence, and advance science-were the most commonly cited foundational elements to ensure progress.Conclusions and Relevance: The action priorities and essential infrastructure needs represent major opportunities to improve health outcomes and increase efficiency and value in the health system. As the new US administration and Congress chart the future of health and health care for the United States, and as health leaders across the country contemplate future directions for their programs and initiatives, their leadership and strategic investment in these priorities will be essential for achieving significant progress. [ABSTRACT FROM AUTHOR]

This Viewpoint summarizes a report from the National Academies of Sciences, Engineering, and Medicine that details the suboptimal inclusion of women and underrepresented racial and ethnic groups in US research studies and provides approaches to better elucidate barriers, facilitators, and best practices in this endeavor. [ABSTRACT FROM AUTHOR]

This Viewpoint argues that equitable health care is not possible without the delivery of high-quality care and vice versa. [ABSTRACT FROM AUTHOR]

This Viewpoint describes the connections between the US opioid use disorder (OUD) epidemic and crises in health care workforce well-being and describes a collaboration between the National Academy of Medicine (NAM) and Federation of State Medical Boards (FSMB) to address both and harmonize regulatory standards and practices where possible. [ABSTRACT FROM AUTHOR]

The authors offer insights on U.S. public health and quality of medical care since the publication of the report "To Err Is Human," by the U.S. Institute of Medicine (IOM) in 2000. Topics discussed include the way then U.S. President Bill Clinton announced measures to improve health care quality and patient safety, the recorded decline in hospital-acquired conditions such as adverse drug events, and the shortcomings of health systems prior to the coronavirus disease 2019 (COVID-19) pandemic.

This Viewpoint summarizes recommendations from the National Academy of Medicine's Committee on Systems Approaches to Improve Patient Care by Supporting Clinician Well-Being, which proposes creation of more positive work and learning environments, reduction of administrative burdens, development of human-centered technology, provision of health support to physicians, and investments in research to better balance the work demands with resources available to clinicians. [ABSTRACT FROM AUTHOR]

In this Viewpoint the president of NAM and the former CEO of AAAS emphasize the importance of approaching opioid use disorder (OUD) as a chronic brain disease and of using evidence-based FDA-approved interventions to manage it, urging clinicians to overcome any personal biases that might interfere with provision of evidence-based care to help patients with OUD recover from their addiction. [ABSTRACT FROM AUTHOR]

The authors offer a response to a commentary on their study about physician burnout. Topics discussed include work system factors that contribute to clinician burnout and affect patient care, emphasis in the guidelines for designing well-being systems, and the need of clinicians together with patients and caregivers to be involved in developing and implementing system interventions.

The article discusses the role of precision medicine in U.S. health care services. Topics include the need for randomized clinical trial (RCT) evidence on the effectiveness of precision medicine, the use of genomic information as part of electronic health records (EHRs), and drug development in relation to precision medicine.

The author presents her thoughts on the the benefits of the National Academy of Medicine (NAM), a U.S. scientific academy previously known as the Institute of Medicine (IOM). He looks at how NAM can change the health care system through expansion, technological innovations, and leadership. The article goes on to outline NAM goals for health and medicine priorities as well as preparation for future public health concerns.

The author discusses ways to restore the progress of the U.S. in biomedical research. Topics discussed include an article within the issue about other countries' efforts to outpace the U.S., decrease in U.S. medical research spending between 2004 and 2012, and need for strategic partnerships involving governments, universities and industry to use their expertise to enhance research support.