A country such as the United States, which spends more money on health care than any other country, should have a trauma system that is a model for other nations. Whilst that may seem like a natural assumption, the reality may be that the U.S. system is a more like a misadventure. The American trauma system is young, not well-organised, faces serious economic challenges, and lacks outcomes data and performance indicators. Before I raise questions about the future, let us review the current state of affairs.
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