Cofounder and director of The Hastings Center, the biomedical/ethical think tank on the Hudson, Callahan faults underlying assumptions for the crisis of health care in America. These assumptions ate embodied in statements by the World Health Organization that ""Everyone has a right to a standard of living adequate for the health and well-being of himself and his family. . ."" The problem is rights, Callahan avers; in a nation as strongly individualistic as America, desires become needs become rights. The pursuit of health becomes an end in itself, employing all the latest tools and tricks of high-tech medicine with the aim of curing all disease and postponing death. Such beliefs are folly, Callahan says, and when they are compounded by unwillingness to pay, have succeeded only in driving up the national cost of health care to the 1989 figure of $550 billion--while other programs, notably education, are left to stagnate. Callahan's solution demands a radical change in values. People must learn to set limits, live with ""reasonable"" health, make decisions based on quality of life, better equity, and expectations that a better, more balanced society will come from ""wise"" choices. Callahan is finn on the need for a universal health-insurance system and opposes all solutions based on making systems more cost-conscious and efficient. They will fail, he says, as long as they ignore the structural dynamic of an aging society, belief in medical progress, and public demand. No question about it, Callahan's strong medicine will go down badly with many individuals and groups--older Americans, those with rare disorders, AIDS patients, and politicians on either the right or the left. Nor does Callahan seem to see the point that much biomedical research is driven not to cure disease but out of curiosity to understand the living organism. He seems to be saying that we don't need to advance because we have already reached an adequate life span. This foreclosing of the future is unbecoming in one so disposed to rewriting the American social, political, and moral agenda.