If we can decode the human genome and fashion working machines out of atoms, why can't we navigate the quagmire that is our health care system? In this important new book, Julius Richmond and Rashi Fein recount the fraught history of health care in America since the 1960s. After the advent of Medicare and Medicaid and with the progressive goal to make advances in medical care available to all, medical costs began their upward spiral. Cost control measures failed and led to the HMO revolution, turning patients into consumers and doctors into providers. The swelling ranks of Americans without any insurance at all dragged the United States to the bottom of the list of industrialized nations.

Over the last century medical education was also profoundly transformed into today's powerful triumvirate of academic medical centers, schools of medicine and public health, and research programs, all of which have shaped medical practice and medical care. The authors show how the promises of medical advances have not been matched either by financing or by delivery of care.

As a new crisis looms, and the existing patchwork of insurance is poised to unravel, American leaders must again take up the question of health care. This book brings the voice of reason and the promise of compromise to that debate.

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