Health care reform: historical and current perspectives

Health care in America, criticized today by patients and physicians alike, developed incrementally throughout the twentieth century into a system unique to the United States. Each effort to change it led to unintended consequences. There are many current proposals by presidential candidates and members of Congress for reform of the fragmentation of payment for, access to, and quality of care. There is increasing pressure from many sources to provide a solution. Will 2004 be the year we find it?