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It is a general held perception by the American people that despite the issues in the health care system like high coverage costs, it is by far the most efficient healthcare system in the world. A recent survey of the American public showed that more than 55% believed that they receive high quality medical care in comparison to other nations (Docteur 2009, p1). The system is able to provide this high level of quality due to the well defined boundaries of its various components. Nursing homes and general acute hospitals have gained due importance in the American healthcare system.

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