Since World War II, considerable advances have been made in the area of health-care services. These include better 1 to health care (particularly for the poor and minorities), improvements in physical plants, and increased numbers of physicians and other health 2 All have played a part in the recent improvement in life 3 . But there is mounting criticism of the large 4 gaps in access, unrestrained cost inflation, the further fragmentation of service, excessive indulgence in 5 high-technology “gadgeteering,” and a 6 in doctor-patient relationships. In recent years proposed panaceas and new programs, small and large, have proliferated at a feverish 7 and disappointments 8 at almost the same rate. This has led to an increased 9 -“everything has been tried and nothing works”-which sometimes 10 on cynicism or even nihilism. This pessimism, in part, 11 from, expecting too much 12 health care. It must be realized that care is, for most people, a 13 experience, often 14 by fear and unwelcome results. Although there is vast room for improvement, health care will always 15 some unpleasantness and frustration. 16 , the 17 of medical science are limited. Humpty-Dumpty cannot always be 18 together again. Too many physicians are reluctant to admit their limitations to patients; too many patients and families are unwilling to accept such realities. Nor is it true that everything has been tried and nothing works. The fact is, except for most 19 and dedicated, there were no incentives to seek change or to practice self-restraint or frugality. In this 20 , it is not fair to condemn as all attempted experiments; it may be more accurate to say many never had a fair trial.