As we enter the full swing of the 1992 election campaign, the public is being deluged with proposals to reform American medicine. No one seriously doubts that American medical care is financially troubled and increasingly inaccessible to many. In 1991, total health expenditures were approximately $740 billion, yet thirty-four million Americans-about 14% of the population- were without health insurance and countless more were underinsured. Some health insurance plans are collapsing. Others struggle to contain premium increases two and three times the rate of general inflation with "managed care" policies that not only restrict choices but also alienate many patients and physicians alike. Survey after survey finds a majority of Americans dissatisfied with the cost of medical care and fearful about their futures.

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