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Why is it so difficult to find a good doctor, and see the doctor when you have a problem? Why are you told to "go to the emergency room?" Why is your "doctor" a nurse practitioner? The U.S. health care system, heralded as the finest in the world, has been in decline for a number of years. Here are the explanations for the decline in availability of primary health care, its increasing cost, and the increasingly impersonal care encountered by the patient. Dr. Rosenblum, chosen by his peers as a leading physician in his community, clarifies the many issues contributing to deterioration of health care. He employs his experience as an internist, and interviews with key individuals involved in health policy and health care delivery. He proposes solutions to halt the disintegration of primary health care, which if restored to its former position of prominence, would reverse the downhill course of medical care in the United States.