Hospital City, Health Care Nation

Hospital City, Health Care Nation

Author: Guian A. McKee

Publisher: University of Pennsylvania Press

Published: 2023-03-07

Total Pages: 393

ISBN-13: 1512823929

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Hospital City, Health Care Nation recasts the story of the U.S. health care system by emphasizing its economic, social, and medical importance in American communities. Focusing on urban hospitals and academic medical centers, the book argues that the country's high level of health care spending has allowed such institutions to become vital, if often problematic, economic anchors for communities. Yet that spending has also constrained possibilities for comprehensive health care reform over many decades, even after the passage of the Affordable Care Act in 2010. At the same time, the role of hospitals in urban renewal, in community health provision, and as employers of low-wage workers has contributed directly to racial health disparities. Guian A. McKee explores these issues through a detailed historical case study of Baltimore's Johns Hopkins Hospital while also tracing their connections across governmental scales--local, state, and federal. He shows that health care spending and its consequences, rather than insurance coverage alone, are core issues in the decades-long struggle over the American health care system. In particular, Hospital City, Health Care Nation points to the increased role of financial capital after the 1960s in shaping not only hospital growth but also the underlying character of these vital institutions. The book shows how hospitals' quest for capital has interacted with structural racism and inequality to shape and constrain the U.S. health care system. Building on this reassessment of the hospital system, its politics, and its financing, Hospital City, Health Care Nation offers ideas for the next steps in health care reform.


Book Synopsis Hospital City, Health Care Nation by : Guian A. McKee

Download or read book Hospital City, Health Care Nation written by Guian A. McKee and published by University of Pennsylvania Press. This book was released on 2023-03-07 with total page 393 pages. Available in PDF, EPUB and Kindle. Book excerpt: Hospital City, Health Care Nation recasts the story of the U.S. health care system by emphasizing its economic, social, and medical importance in American communities. Focusing on urban hospitals and academic medical centers, the book argues that the country's high level of health care spending has allowed such institutions to become vital, if often problematic, economic anchors for communities. Yet that spending has also constrained possibilities for comprehensive health care reform over many decades, even after the passage of the Affordable Care Act in 2010. At the same time, the role of hospitals in urban renewal, in community health provision, and as employers of low-wage workers has contributed directly to racial health disparities. Guian A. McKee explores these issues through a detailed historical case study of Baltimore's Johns Hopkins Hospital while also tracing their connections across governmental scales--local, state, and federal. He shows that health care spending and its consequences, rather than insurance coverage alone, are core issues in the decades-long struggle over the American health care system. In particular, Hospital City, Health Care Nation points to the increased role of financial capital after the 1960s in shaping not only hospital growth but also the underlying character of these vital institutions. The book shows how hospitals' quest for capital has interacted with structural racism and inequality to shape and constrain the U.S. health care system. Building on this reassessment of the hospital system, its politics, and its financing, Hospital City, Health Care Nation offers ideas for the next steps in health care reform.

The Hospital

The Hospital

Author: Brian Alexander

Publisher: St. Martin's Griffin

Published: 2022-03-08

Total Pages: 0

ISBN-13: 1250828686

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"An intimate, heart wrenching portrait of one small hospital that reveals the magnitude of America's health care crises. By following the struggle for survival of one small-town hospital, and the patients who walk, or are carried, through its doors, The Hospital takes readers into the world of the American medical industry in a way no book has done before."--Publisher's description.


Book Synopsis The Hospital by : Brian Alexander

Download or read book The Hospital written by Brian Alexander and published by St. Martin's Griffin. This book was released on 2022-03-08 with total page 0 pages. Available in PDF, EPUB and Kindle. Book excerpt: "An intimate, heart wrenching portrait of one small hospital that reveals the magnitude of America's health care crises. By following the struggle for survival of one small-town hospital, and the patients who walk, or are carried, through its doors, The Hospital takes readers into the world of the American medical industry in a way no book has done before."--Publisher's description.

Inside National Health Reform

Inside National Health Reform

Author: John E. McDonough

Publisher: Univ of California Press

Published: 2012-09-03

Total Pages: 368

ISBN-13: 0520274520

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A guide to the Affordable Care Act, our new national health care law. An account of the process from the 2008 presidential campaign to the moment in 2010 when the bill was signed into law before anyone had a chance to digest the document. At a time when the nation is taking a second look at the ACA, "Inside National Health Reform" provides essential information for Americans to review the governmental processes and politics in enacting this legislation.


Book Synopsis Inside National Health Reform by : John E. McDonough

Download or read book Inside National Health Reform written by John E. McDonough and published by Univ of California Press. This book was released on 2012-09-03 with total page 368 pages. Available in PDF, EPUB and Kindle. Book excerpt: A guide to the Affordable Care Act, our new national health care law. An account of the process from the 2008 presidential campaign to the moment in 2010 when the bill was signed into law before anyone had a chance to digest the document. At a time when the nation is taking a second look at the ACA, "Inside National Health Reform" provides essential information for Americans to review the governmental processes and politics in enacting this legislation.

An American Sickness

An American Sickness

Author: Elisabeth Rosenthal

Publisher: Penguin

Published: 2017-04-11

Total Pages: 434

ISBN-13: 0698407180

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A New York Times bestseller/Washington Post Notable Book of 2017/NPR Best Books of 2017/Wall Street Journal Best Books of 2017 "This book will serve as the definitive guide to the past and future of health care in America.”—Siddhartha Mukherjee, Pulitzer Prize-winning author of The Emperor of All Maladies and The Gene At a moment of drastic political upheaval, An American Sickness is a shocking investigation into our dysfunctional healthcare system - and offers practical solutions to its myriad problems. In these troubled times, perhaps no institution has unraveled more quickly and more completely than American medicine. In only a few decades, the medical system has been overrun by organizations seeking to exploit for profit the trust that vulnerable and sick Americans place in their healthcare. Our politicians have proven themselves either unwilling or incapable of reining in the increasingly outrageous costs faced by patients, and market-based solutions only seem to funnel larger and larger sums of our money into the hands of corporations. Impossibly high insurance premiums and inexplicably large bills have become facts of life; fatalism has set in. Very quickly Americans have been made to accept paying more for less. How did things get so bad so fast? Breaking down this monolithic business into the individual industries—the hospitals, doctors, insurance companies, and drug manufacturers—that together constitute our healthcare system, Rosenthal exposes the recent evolution of American medicine as never before. How did healthcare, the caring endeavor, become healthcare, the highly profitable industry? Hospital systems, which are managed by business executives, behave like predatory lenders, hounding patients and seizing their homes. Research charities are in bed with big pharmaceutical companies, which surreptitiously profit from the donations made by working people. Patients receive bills in code, from entrepreneurial doctors they never even saw. The system is in tatters, but we can fight back. Dr. Elisabeth Rosenthal doesn't just explain the symptoms, she diagnoses and treats the disease itself. In clear and practical terms, she spells out exactly how to decode medical doublespeak, avoid the pitfalls of the pharmaceuticals racket, and get the care you and your family deserve. She takes you inside the doctor-patient relationship and to hospital C-suites, explaining step-by-step the workings of a system badly lacking transparency. This is about what we can do, as individual patients, both to navigate the maze that is American healthcare and also to demand far-reaching reform. An American Sickness is the frontline defense against a healthcare system that no longer has our well-being at heart.


Book Synopsis An American Sickness by : Elisabeth Rosenthal

Download or read book An American Sickness written by Elisabeth Rosenthal and published by Penguin. This book was released on 2017-04-11 with total page 434 pages. Available in PDF, EPUB and Kindle. Book excerpt: A New York Times bestseller/Washington Post Notable Book of 2017/NPR Best Books of 2017/Wall Street Journal Best Books of 2017 "This book will serve as the definitive guide to the past and future of health care in America.”—Siddhartha Mukherjee, Pulitzer Prize-winning author of The Emperor of All Maladies and The Gene At a moment of drastic political upheaval, An American Sickness is a shocking investigation into our dysfunctional healthcare system - and offers practical solutions to its myriad problems. In these troubled times, perhaps no institution has unraveled more quickly and more completely than American medicine. In only a few decades, the medical system has been overrun by organizations seeking to exploit for profit the trust that vulnerable and sick Americans place in their healthcare. Our politicians have proven themselves either unwilling or incapable of reining in the increasingly outrageous costs faced by patients, and market-based solutions only seem to funnel larger and larger sums of our money into the hands of corporations. Impossibly high insurance premiums and inexplicably large bills have become facts of life; fatalism has set in. Very quickly Americans have been made to accept paying more for less. How did things get so bad so fast? Breaking down this monolithic business into the individual industries—the hospitals, doctors, insurance companies, and drug manufacturers—that together constitute our healthcare system, Rosenthal exposes the recent evolution of American medicine as never before. How did healthcare, the caring endeavor, become healthcare, the highly profitable industry? Hospital systems, which are managed by business executives, behave like predatory lenders, hounding patients and seizing their homes. Research charities are in bed with big pharmaceutical companies, which surreptitiously profit from the donations made by working people. Patients receive bills in code, from entrepreneurial doctors they never even saw. The system is in tatters, but we can fight back. Dr. Elisabeth Rosenthal doesn't just explain the symptoms, she diagnoses and treats the disease itself. In clear and practical terms, she spells out exactly how to decode medical doublespeak, avoid the pitfalls of the pharmaceuticals racket, and get the care you and your family deserve. She takes you inside the doctor-patient relationship and to hospital C-suites, explaining step-by-step the workings of a system badly lacking transparency. This is about what we can do, as individual patients, both to navigate the maze that is American healthcare and also to demand far-reaching reform. An American Sickness is the frontline defense against a healthcare system that no longer has our well-being at heart.

Five Days at Memorial

Five Days at Memorial

Author: Sheri Fink

Publisher: Crown

Published: 2016-01-26

Total Pages: 602

ISBN-13: 0307718972

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NEW YORK TIMES BESTSELLER • The award-winning book that inspired an Apple Original series from Apple TV+ • A landmark investigation of patient deaths at a New Orleans hospital ravaged by Hurricane Katrina—and the suspenseful portrayal of the quest for truth and justice—from a Pulitzer Prize–winning physician and reporter “An amazing tale, as inexorable as a Greek tragedy and as gripping as a whodunit.”—Dallas Morning News After Hurricane Katrina struck and power failed, amid rising floodwaters and heat, exhausted staff at Memorial Medical Center designated certain patients last for rescue. Months later, a doctor and two nurses were arrested and accused of injecting some of those patients with life-ending drugs. Five Days at Memorial, the culmination of six years of reporting by Pulitzer Prize winner Sheri Fink, unspools the mystery, bringing us inside a hospital fighting for its life and into the most charged questions in health care: which patients should be prioritized, and can health care professionals ever be excused for hastening death? Transforming our understanding of human nature in crisis, Five Days at Memorial exposes the hidden dilemmas of end-of-life care and reveals how ill-prepared we are for large-scale disasters—and how we can do better. ONE OF THE TEN BEST BOOKS OF THE YEAR: The New York Times Book Review • ONE OF THE BEST BOOKS OF THE YEAR: Chicago Tribune, Seattle Times, Entertainment Weekly, Christian Science Monitor, Kansas City Star WINNER: National Book Critics Circle Award, J. Anthony Lukas Book Prize, PEN/John Kenneth Galbraith Award, Los Angeles Times Book Prize, Ridenhour Book Prize, American Medical Writers Association Medical Book Award, National Association of Science Writers Science in Society Award


Book Synopsis Five Days at Memorial by : Sheri Fink

Download or read book Five Days at Memorial written by Sheri Fink and published by Crown. This book was released on 2016-01-26 with total page 602 pages. Available in PDF, EPUB and Kindle. Book excerpt: NEW YORK TIMES BESTSELLER • The award-winning book that inspired an Apple Original series from Apple TV+ • A landmark investigation of patient deaths at a New Orleans hospital ravaged by Hurricane Katrina—and the suspenseful portrayal of the quest for truth and justice—from a Pulitzer Prize–winning physician and reporter “An amazing tale, as inexorable as a Greek tragedy and as gripping as a whodunit.”—Dallas Morning News After Hurricane Katrina struck and power failed, amid rising floodwaters and heat, exhausted staff at Memorial Medical Center designated certain patients last for rescue. Months later, a doctor and two nurses were arrested and accused of injecting some of those patients with life-ending drugs. Five Days at Memorial, the culmination of six years of reporting by Pulitzer Prize winner Sheri Fink, unspools the mystery, bringing us inside a hospital fighting for its life and into the most charged questions in health care: which patients should be prioritized, and can health care professionals ever be excused for hastening death? Transforming our understanding of human nature in crisis, Five Days at Memorial exposes the hidden dilemmas of end-of-life care and reveals how ill-prepared we are for large-scale disasters—and how we can do better. ONE OF THE TEN BEST BOOKS OF THE YEAR: The New York Times Book Review • ONE OF THE BEST BOOKS OF THE YEAR: Chicago Tribune, Seattle Times, Entertainment Weekly, Christian Science Monitor, Kansas City Star WINNER: National Book Critics Circle Award, J. Anthony Lukas Book Prize, PEN/John Kenneth Galbraith Award, Los Angeles Times Book Prize, Ridenhour Book Prize, American Medical Writers Association Medical Book Award, National Association of Science Writers Science in Society Award

The Price We Pay

The Price We Pay

Author: Marty Makary

Publisher: Bloomsbury Publishing USA

Published: 2019-09-10

Total Pages: 305

ISBN-13: 1635574129

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New York Times bestseller Business Book of the Year--Association of Business Journalists From the New York Times bestselling author comes an eye-opening, urgent look at America's broken health care system--and the people who are saving it--now with a new Afterword by the author. "A must-read for every American." --Steve Forbes, editor-in-chief, FORBES One in five Americans now has medical debt in collections and rising health care costs today threaten every small business in America. Dr. Makary, one of the nation's leading health care experts, travels across America and details why health care has become a bubble. Drawing from on-the-ground stories, his research, and his own experience, The Price We Pay paints a vivid picture of the business of medicine and its elusive money games in need of a serious shake-up. Dr. Makary shows how so much of health care spending goes to things that have nothing to do with health and what you can do about it. Dr. Makary challenges the medical establishment to remember medicine's noble heritage of caring for people when they are vulnerable. The Price We Pay offers a road map for everyday Americans and business leaders to get a better deal on their health care, and profiles the disruptors who are innovating medical care. The movement to restore medicine to its mission, Makary argues, is alive and well--a mission that can rebuild the public trust and save our country from the crushing cost of health care.


Book Synopsis The Price We Pay by : Marty Makary

Download or read book The Price We Pay written by Marty Makary and published by Bloomsbury Publishing USA. This book was released on 2019-09-10 with total page 305 pages. Available in PDF, EPUB and Kindle. Book excerpt: New York Times bestseller Business Book of the Year--Association of Business Journalists From the New York Times bestselling author comes an eye-opening, urgent look at America's broken health care system--and the people who are saving it--now with a new Afterword by the author. "A must-read for every American." --Steve Forbes, editor-in-chief, FORBES One in five Americans now has medical debt in collections and rising health care costs today threaten every small business in America. Dr. Makary, one of the nation's leading health care experts, travels across America and details why health care has become a bubble. Drawing from on-the-ground stories, his research, and his own experience, The Price We Pay paints a vivid picture of the business of medicine and its elusive money games in need of a serious shake-up. Dr. Makary shows how so much of health care spending goes to things that have nothing to do with health and what you can do about it. Dr. Makary challenges the medical establishment to remember medicine's noble heritage of caring for people when they are vulnerable. The Price We Pay offers a road map for everyday Americans and business leaders to get a better deal on their health care, and profiles the disruptors who are innovating medical care. The movement to restore medicine to its mission, Makary argues, is alive and well--a mission that can rebuild the public trust and save our country from the crushing cost of health care.

The Future of the Public's Health in the 21st Century

The Future of the Public's Health in the 21st Century

Author: Institute of Medicine

Publisher: National Academies Press

Published: 2003-02-01

Total Pages: 536

ISBN-13: 0309133181

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The anthrax incidents following the 9/11 terrorist attacks put the spotlight on the nation's public health agencies, placing it under an unprecedented scrutiny that added new dimensions to the complex issues considered in this report. The Future of the Public's Health in the 21st Century reaffirms the vision of Healthy People 2010, and outlines a systems approach to assuring the nation's health in practice, research, and policy. This approach focuses on joining the unique resources and perspectives of diverse sectors and entities and challenges these groups to work in a concerted, strategic way to promote and protect the public's health. Focusing on diverse partnerships as the framework for public health, the book discusses: The need for a shift from an individual to a population-based approach in practice, research, policy, and community engagement. The status of the governmental public health infrastructure and what needs to be improved, including its interface with the health care delivery system. The roles nongovernment actors, such as academia, business, local communities and the media can play in creating a healthy nation. Providing an accessible analysis, this book will be important to public health policy-makers and practitioners, business and community leaders, health advocates, educators and journalists.


Book Synopsis The Future of the Public's Health in the 21st Century by : Institute of Medicine

Download or read book The Future of the Public's Health in the 21st Century written by Institute of Medicine and published by National Academies Press. This book was released on 2003-02-01 with total page 536 pages. Available in PDF, EPUB and Kindle. Book excerpt: The anthrax incidents following the 9/11 terrorist attacks put the spotlight on the nation's public health agencies, placing it under an unprecedented scrutiny that added new dimensions to the complex issues considered in this report. The Future of the Public's Health in the 21st Century reaffirms the vision of Healthy People 2010, and outlines a systems approach to assuring the nation's health in practice, research, and policy. This approach focuses on joining the unique resources and perspectives of diverse sectors and entities and challenges these groups to work in a concerted, strategic way to promote and protect the public's health. Focusing on diverse partnerships as the framework for public health, the book discusses: The need for a shift from an individual to a population-based approach in practice, research, policy, and community engagement. The status of the governmental public health infrastructure and what needs to be improved, including its interface with the health care delivery system. The roles nongovernment actors, such as academia, business, local communities and the media can play in creating a healthy nation. Providing an accessible analysis, this book will be important to public health policy-makers and practitioners, business and community leaders, health advocates, educators and journalists.

No One Was Turned Away

No One Was Turned Away

Author: Sandra Opdycke

Publisher: Oxford University Press

Published: 2000-09-28

Total Pages: 264

ISBN-13: 0195349814

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No One Was Turned Away is a book about the importance of public hospitals to New York City. At a time when less and less value seems to be placed on public institutions, argues author Sandra Opdycke, it is both useful and prudent to consider what this particular set of public institutions has meant to this particular city over the last hundred years, and to ponder what its loss might mean as well. Opdycke suggests that if these public hospitals close or convert to private management--as is currently being discussed--then a vital element of the civic life of New York City will be irretrievably lost. The story is told primarily through the history of Bellevue Hospital, the largest public hospital in the city and the oldest in the nation. Following Bellevue through the twentieth century, Opdycke meticulously charts the fluctuating fortunes of the city's public hospital system. Readers will learn how medical technology, urban politics, changing immigration patterns, economic booms and busts, labor unions, health insurance, Medicaid, and managed care have interacted to shape both the social and professional environments of New York's public hospitals. Having entered the twentieth century with high hopes for a grand expansion, Bellevue now faces financial and political pressures so acute that its very future is in doubt. In order to give context to the Bellevue experience, Opdycke also tracks the history of a private facility over the same century: New York Hospital. By noting the points at which the paths of these two mighty institutions have overlapped--as well as the ways in which they have diverged--this book clearly and persuasively highlights the significance of public hospitals to the city. No One Was Turned Away shows that private facilities like New York Hospital have generally provided superb care for their patients, but that in every era they have also excluded certain groups. This exclusion has occurred for various reasons, such as patients' diagnoses, their social characteristics, behavior, or financial status--or simply because of a lack of unoccupied beds. Fortunately, however, year in and year out, Bellevue and its fellow public facilities have acted as the city's medical safety net. Opdycke's book maintains that public hospitals will be as essential in the future as they have been in the past. This is a thoughtful and well-written study that will appeal to anyone interested in the history of medicine, public policy, urban affairs, or the City of New York.


Book Synopsis No One Was Turned Away by : Sandra Opdycke

Download or read book No One Was Turned Away written by Sandra Opdycke and published by Oxford University Press. This book was released on 2000-09-28 with total page 264 pages. Available in PDF, EPUB and Kindle. Book excerpt: No One Was Turned Away is a book about the importance of public hospitals to New York City. At a time when less and less value seems to be placed on public institutions, argues author Sandra Opdycke, it is both useful and prudent to consider what this particular set of public institutions has meant to this particular city over the last hundred years, and to ponder what its loss might mean as well. Opdycke suggests that if these public hospitals close or convert to private management--as is currently being discussed--then a vital element of the civic life of New York City will be irretrievably lost. The story is told primarily through the history of Bellevue Hospital, the largest public hospital in the city and the oldest in the nation. Following Bellevue through the twentieth century, Opdycke meticulously charts the fluctuating fortunes of the city's public hospital system. Readers will learn how medical technology, urban politics, changing immigration patterns, economic booms and busts, labor unions, health insurance, Medicaid, and managed care have interacted to shape both the social and professional environments of New York's public hospitals. Having entered the twentieth century with high hopes for a grand expansion, Bellevue now faces financial and political pressures so acute that its very future is in doubt. In order to give context to the Bellevue experience, Opdycke also tracks the history of a private facility over the same century: New York Hospital. By noting the points at which the paths of these two mighty institutions have overlapped--as well as the ways in which they have diverged--this book clearly and persuasively highlights the significance of public hospitals to the city. No One Was Turned Away shows that private facilities like New York Hospital have generally provided superb care for their patients, but that in every era they have also excluded certain groups. This exclusion has occurred for various reasons, such as patients' diagnoses, their social characteristics, behavior, or financial status--or simply because of a lack of unoccupied beds. Fortunately, however, year in and year out, Bellevue and its fellow public facilities have acted as the city's medical safety net. Opdycke's book maintains that public hospitals will be as essential in the future as they have been in the past. This is a thoughtful and well-written study that will appeal to anyone interested in the history of medicine, public policy, urban affairs, or the City of New York.

Transforming Health Care

Transforming Health Care

Author: Charles Kenney

Publisher: CRC Press

Published: 2010-11-08

Total Pages: 248

ISBN-13: 1439863091

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For decades, the manufacturing industry has employed the Toyota Production System the most powerful production method in the world to reduce waste, improve quality, reduce defects and increase worker productivity. In 2001, Virginia Mason Medical Center, an integrated healthcare delivery system in Seattle, Washington set out to achieve its compe


Book Synopsis Transforming Health Care by : Charles Kenney

Download or read book Transforming Health Care written by Charles Kenney and published by CRC Press. This book was released on 2010-11-08 with total page 248 pages. Available in PDF, EPUB and Kindle. Book excerpt: For decades, the manufacturing industry has employed the Toyota Production System the most powerful production method in the world to reduce waste, improve quality, reduce defects and increase worker productivity. In 2001, Virginia Mason Medical Center, an integrated healthcare delivery system in Seattle, Washington set out to achieve its compe

Which Country Has the World's Best Health Care?

Which Country Has the World's Best Health Care?

Author: Ezekiel J. Emanuel

Publisher: PublicAffairs

Published: 2020-06-16

Total Pages: 464

ISBN-13: 1541797728

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The preeminent doctor and bioethicist Ezekiel Emanuel is repeatedly asked one question: Which country has the best healthcare? He set off to find an answer. The US spends more than any other nation, nearly $4 trillion, on healthcare. Yet, for all that expense, the US is not ranked #1 -- not even close. In Which Country Has the World's Best Healthcare? Ezekiel Emanuel profiles eleven of the world's healthcare systems in pursuit of the best or at least where excellence can be found. Using a unique comparative structure, the book allows healthcare professionals, patients, and policymakers alike to know which systems perform well, and why, and which face endemic problems. From Taiwan to Germany, Australia to Switzerland, the most inventive healthcare providers tackle a global set of challenges -- in pursuit of the best healthcare in the world.


Book Synopsis Which Country Has the World's Best Health Care? by : Ezekiel J. Emanuel

Download or read book Which Country Has the World's Best Health Care? written by Ezekiel J. Emanuel and published by PublicAffairs. This book was released on 2020-06-16 with total page 464 pages. Available in PDF, EPUB and Kindle. Book excerpt: The preeminent doctor and bioethicist Ezekiel Emanuel is repeatedly asked one question: Which country has the best healthcare? He set off to find an answer. The US spends more than any other nation, nearly $4 trillion, on healthcare. Yet, for all that expense, the US is not ranked #1 -- not even close. In Which Country Has the World's Best Healthcare? Ezekiel Emanuel profiles eleven of the world's healthcare systems in pursuit of the best or at least where excellence can be found. Using a unique comparative structure, the book allows healthcare professionals, patients, and policymakers alike to know which systems perform well, and why, and which face endemic problems. From Taiwan to Germany, Australia to Switzerland, the most inventive healthcare providers tackle a global set of challenges -- in pursuit of the best healthcare in the world.