There is no argument that the quality of care in the United States is less than ideal.  Although we have great care in certain times, there are also those instances where patients are receiving less than "good" care.  As mentioned by other people, improving the quality of care is extremely difficult in the current system.  This is a result of the vast complexities, specialities and differences in the health care that is delivered from state to state.  It is extremely difficult to obtain a measure of the level of care being delivered when it is not uniform and consistent across the board.  I think the greatest way to achieve these improvements in quality of care would be to implement a "standard of care".  For instance, in the emergency medical field (both in the ER and prehospital setting) there is a standard of care that clinicians must abide by and deliver to all patients.  The reason this field has a consistent way of delivering care is because emergent situations open the flood gates to mistakes and missed diagnoses.  With all of the rushing around and immediate thinking/decision making, it is imperative that health professionals have a routine pattern of dealing with these cases.

Now I know that even the ERs have differences and disparities in care, however, as a whole, they are much more consistent than other areas.  If the entire health care system could figure out a way to be more continuous in its efforts, I think we would see a vast improvement in the quality to which our patients receive care.

Finally, I think a big problem that is contributing to the low quality in care is the record keeping and hastiness of clinicians.  I have personally seen numerous cases where patients were given wrong procedures, in which some resulted in permanent damage and death.  There really is no excuse that a patient's chart should have wrong information on it or have tests ordered on their chart that were really supposed to go to another patient.  Therefore, I feel as though the whole process of chart taking/reviews needs to be improved; maybe nationwide EMRs would do the trick.  

Regardless of all these things, it is evident that something needs to be done to improve the quality of care being delivered in our nation.  Perhaps this will come with reform and maybe it won't; however, this time around it needs to be a monumental change and not just incremental differences.