The U.S. healthcare system is failing. It is run like a business, increasingly focused on generating income for insurers and providers rather than providing care for patients. It is supported by investors and private markets seeking to grow revenue and resist regulation, thus contributing to higher costs and lessened public accountability. Meanwhile, forty-six million Americans are without insurance. Health care expenditures are rising at a rate of 7 percent a year, three times the rate of inflation. Dr. Arnold Relman is one of the most respected physicians and healthcare advocates in our country. This book, based on sixty years' experience in medicine, is a clarion call not just to politicians and patients but to the medical profession to evolve a new structure for healthcare, based on voluntary private contracts between individuals and not-for-profit, multi-specialty groups of physicians. Physicians would be paid mainly by salaries and would submit no bills for their services. All health care facilities would be not-for-profit. The savings from reduced administrative overhead and the elimination of billing fraud would be enormous. Healthcare may be our greatest national problem, but the provocative, sensible arguments in this book will provide a catalyst for change.