A book not exactly calculated to win the hearts and minds of the American medical business--including not just the AMA but big drug companies, private health insurance agencies, all those who profit from the way medical care is ""bought and sold"" in America. And profit (richly) they do. And ""business"" it is: ""One set of people and institutions that care for the middle class and rich and another set that care mainly for the poor."" And for everyone, extravagantly expensive (often incompetent) doctors, unnecessary surgery (""one out of every five or six operations is medically unjustified""); unnecessary hospitalization, too many surgeons, too few GPs (not ""very highly admired"" within the profession); and far too many drugs, often ineffective and overpriced as well. It's a business which has been given the independence and freedom to exploit--existing as it does without the checks and balances built into almost any other profession. Spencer Klaw's reasonable conclusion (one can hardly imagine any other) is that while changes in the way that ""medical care in America is organized and paid for"" may have ""disagreeable consequences"" for some, making ""medical care available, at little or no out-of-pocket cost, to everybody who needs it"" is possible and is desirable. He argues (as did Senator Kennedy) for the passage of a national health insurance scheme, whereby ""everybody would automatically be covered"" with strict ""cost and quality"" controls. A large and serious subject, covered in (sometimes repetitive) detail, necessitating at the least that readers not yet informed learn the painful basics.