The promise and disappointment of U.S. medical care -- How much we spend -- What we get for what we spend -- Trouble in the delivery subsystem -- Why the problems need to be solved and the goals of reform -- What caused these problems, and how can we attack them? -- Competition and the market or the public sector? -- Elements of a solution for increasing access to health care, improving quality of care, and containing health care expenditures -- A short history of health care reform efforts -- The politics of reform : elements of a strategy to break the logjam -- Strategy and compromise.