A graveyard for grand theory

We have failed as a nation to make decent medical care available to all and to control costs. Competing, entrenched interests, more focused on what they have to lose than what they stand to gain, have stymied successive visions of reform. The American public's aversion to risk has compounded the challenge. There is an urgent need for aspiring health system reformers to chart navigable courses through the cross-currents of interest-group power, anxiety, and ambition that have kept reform from succeeding. Some recent proposals offer reason for hope.