Pugnacious arguments in favor of a single-payer health plan for the United States, along with instructions for building a mass movement to get one. In 1994, Andrews took part in the failed campaign for Proposition 186, the California Health Security Act, which called for the creation of a single-payer health plan in that state, thereby eliminating commercial insurance companies from health care. Before getting into the California campaign, however, he sketches a history of health care in this country from the 1930s, when Blue Cross was born, to the 1990s and the floundering health reform efforts of the Clinton administration. In the author's words, it is the story of ""the forces that developed medicine from a set of professions to a corporatized industry."" His antibusiness stance can also be seen in such chapter headings as ""Feeding at the Trough: Insurance Companies"" and in his use of loaded terms like ""fat bankrolls,"" ""slick lobbyists,"" and ""hired guns."" Andrews takes a brief look at health care in Japan, Sweden, and North Vietnam, and a slightly longer one at Germany and Great Britain. Canada, however, gets the most attention, because its single-payer system is, the author insists, the only way to go. Andrews describes in some detail how Proposition 186 was designed for California, how it got on the ballot, who supported it and who opposed it, how the two sides organized, and what strategies did or didn't work. The heart of the book is the author's analysis of the campaign's failure and the lessons to be learned from it. As Andrews sees it, the principal problem was that supporters of Proposition 186 were trying to sell a product when they should have been building a movement. Filled with all the fervor of an uncompromising reformer certain of the truth of his message.