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...

This is a book about the policy process. It discusses the considerations advisers have in mind as they develop and select policy alternatives, the ways each of us might want to think about making decisions, and the lessons we should remember in order to minimize avoidable errors. In writing about his experiences in government, the classroom, and private life, Fein offers insights that apply to people responsible for decisions in many kinds of institutions, at all levels of responsibility.

His anecdotes and the situations he describes are drawn from over fifty years of experience in...