Introduction

THE U.S. HEALTH CARE SYSTEM is notorious for its high costs, which Americans traditionally assumed was the price of excellence. Some American health care is truly superb, but we now know that serious quality problems also plague the system. There is compelling evidence that much care falls well short of excellence, that both too little and too much care is provided, and that alarming rates of medical error persist.

At a personal level, almost everyone has a story about health care. Many of these stories have a happy ending and reveal the extraordinary skill and compassion of doctors and other caregivers. Too often, however, even the happy endings were due to personal determination, connections, or the ongoing intervention of family ...

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