For three decades Dr. Howard Waitzkin has worked 'at the front line of medicine.' As a practitioner of internal medicine and primary care and as a sociologist, he has devoted much of his career to improving health services, especially for poor and underserved patients_migrant workers in California, immigrants living in Southwestern communities, and patients in developing countries of Latin America. In his latest book Dr. Waitzkin offers a comprehensive analysis of the current problems of costs, coverage, and access to medical care in the United States. He takes the reader into the examination room with vivid patient-doctor encounters that portray dilemmas patients frequently face. Many stories are too familiar in this era of rising costs and declining health coverage: A 31-year old diabetic man who died when his Medicaid co-payment spiraled out of reach; a 48-year old woman whose breast cancer metastasized as she waited funding for an outpatient biopsy; a 63-year old man struggling to control high blood pressure after a layoff left him without affordable coverage. The United States today is the only economically developed county in which more than a third of the population is uninsured or under-insured. This new book explains why, just as it offers strategies to improve medical encounters and the health care system as a whole. Changes in Medical care have affected the decision making of doctors, as well as communication between patients and doctors. Dr. Waitzkin describes these important changes in the medical practice. He offers an analysis of how spiraling costs, managed care organizations, declining coverage, and new technologies have changed the decisions and the course of care chosen. Most strikingly, he explains why a community's social and economic conditions have even more impact on health outcomes than the type or quality of available health services. Dr. Waitzkin describes the bold action needed if the United States is to improve the health prospects of its people. Howard Waitzkin lives in a rural area east of Albuquerque, where he is professor of community medicine, internal medicine, and sociology at the University of New Mexico. His award winning research has been featured inThe New York Times, The New England Journal of Medicine, and in national and international wire services.