"A marvelous collection of ideas and insights by first-rate scholars. This book lays a foundation for more creative and effective policymaking." --Stephen M. Shortell, Dean, School of Public Health and Blue Cross of California Distiguished Professor of Health Policy and Management, University of California, Berkeley Health care delivery in the United States is an enormously complex and expensive enterprise that involves a host of competing interests. While arguably the nation offers the most technologically advanced medical care in the world, the American system consistently underperforms relative to its resources. Gaps in financing and service delivery pose major barriers to improving health, reducing disparities, achieving universal insurance coverage, enhancing quality, controlling costs, and meeting the needs of patients and families. Bringing together twenty-five of the nation's leading experts in health care policy and public health, this book provides a much-needed perspective on how our health care system evolved, why we face the challenges that we do, and why reform is so difficult to achieve. The essays tackle tough issues including: socioeconomic disadvantage, obesity, tobacco policy, gun violence, insurance gaps, the rationing of services, medical errors, the nursing shortage, and the pervasive influence of special interests. Linking the nation's health problems to larger political, cultural, and philosophical contexts, Policy Challenges in Modern Health Care offers a compelling look at where we stand and where we need to be headed. David Mechanic is the director of the Institute for Health, Health Care Policy, and Aging Research at Rutgers University and the nationalprogram director of The Robert Wood Johnson Foundation Investigator Awards in Health Policy Research. Lynn B. Ragout is deputy director of the Investigator Awards in Health Policy Resarch. David C. Colby is interim vice president of Research and Evaluation at The Robert Wood Johnson Foundation. James R. Knickman is the president and chief executive officer of the New York Charitable Asset Foundation.