Traditional health care is fragmented, marred by quality and safety defects, with a failure to provide evidence-based care, and huge and unjustifiable variations in practice.

There is abundant evidence that traditional means of delivering health care are obsolete.

Concerns are deepening about persistent and widening gaps in health status that health care cannot overcome.

Increased spending on health care has never definitively solved the problems of access, quality, or equity.

Non-medical determinants of health indicate that the solutions to health problems lie mainly outside health care.

The current financial crisis may create the urgency and courage to both eliminate the fundamental problems in health care delivery and reduce health disparities.