Introduction: the paradox of excess and deprivation -- Paying for health care -- Access to health care -- Reimbursing health care providers -- How health care is organized-- I: Primary, secondary, and tertiary care -- How health care is organized -- II: Health delivery systems -- Health care workforce and the education of health professionals -- Painful versus painless cost control -- Mechanisms for controlling costs -- Quality of health care -- Prevention of illness -- Long-term care -- Medical ethics and rationing of health care -- Health care in four nations -- Health care reform and national health insurance -- Conflict and change in America's health care system -- Conclusion: tensions and challenges -- Questions and discussion topics.