David Kindig's training as a physician, a health care executive, and his academic work in the field of health policy came together to inspire this innovative approach for extracting a higher quality of care at reasonable cost by establishing clear health outcomes measures as a purchasing standard.

Despite the massive resources it consumes, the American health care system remains under stress. While we are global leaders in technical accomplishments in medicine, the quality of health outcomes we achieve per dollar invested is far from optimal. Neither market nor regulatory reforms have addressed this failure of our system.

In the wake of the failed 1994 federal reform effort the system is changing without legislation through market forces. There is no evidence, however, that these changes are reducing costs, increasing quality, or covering the uninsured.

This book details how Dr. Kindig's plan could work and the stages of implementation. It concludes with an examination of the price of inertia in facing this long-standing problem.

This work will appeal to senior policymakers in the private and public sector, including legislators and staff, officials of corporations, and professional organizations. In addition, faculty and students in schools of medicine, nursing, public health, and business, as well as health services researchers and a sophisticated lay audience will find it interesting.

"...a major contribution to our understanding of the forces driving the health care system and the need to create the incentives for a healthier America in the 21st century." --Philip R. Lee, M.D., former Assistant Secretary for Health, Department of Health and Human Services

David A. Kindig is Professor of Preventive Medicine, University of Wisconsin- Madison School of Medicine.

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