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There have been financial pressures for many years, but the government's cuts are now driving care services to breaking point".
Despite the appeal of EBA, and the widespread recognition of this approach in driving care, they present a number of challenges, and there has been a steady undercurrent of concern about their pervasive acceptance and promotion.
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In many countries, increasing demand for the provision of high quality health care services combined with constraints on health care funding are driving health care systems to seek suitable alternatives to high cost specialist care.
Whatever the driving concerns — care for the horses, fear of deepening embarrassment that I'll Have Another's trainer has a long history of doping violations — the safeguards announced by state racing authorities are extraordinary.
She argued that the certificate program had the effect of driving health care costs up by not allowing more competition and potentially better health care in newer facilities.
A far more practical approach would focus on conditions actually driving health care costs and put tools in place to meaningfully impact and improve that care.
In a New England Journal article last month, Dr. Landers listed forces driving health care into the home: the aging population, "epidemics" of chronic diseases, technological advances, health care consumerism and rapidly escalating health costs.
"Labour's plan to integrate health and social care is vital to tackling the financial pressures on the NHS at the same time as driving up care standards for patients".
"We have to get at the factors that are driving health care costs," he said.
The Europeans, with their own domestic forces driving debate, care not a whit for the U.S. Treasury's advice.
Giving people the power to choose what to have and when to have it is supposed to be the big idea driving social care at the moment.
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Justyna Jupowicz-Kozak
CEO of Professional Science Editing for Scientists @ prosciediting.com