US healthcare and the impact of the changes in the healthcare system on the current and future practice of laboratory medicine are analyzed. Factors considered include – population and government, healthcare expenditure, organization of healthcare delivery (institutions, personnel, healthcare industry, knowledge-personnel production, financing), the impact of managed care, and political and public health issues. The effect of the changing healthcare scene on laboratories and the consequent cost-containment measures for laboratory medicine are examined, including centralization, consolidation, supplier relationships, reengineering and automation (total lab automation), expert systems, CQI, and the move to point-of-care testing.
