The author argues that the "American Way" is incompatible with the US experience of post-World War II capitalism, and that national and individual self-determination are collapsing in the face of profit-seeking social compulsions and the imperatives of global competition. He states that the illusion of free choice and the misguided rhetoric of individualism remain: but they mask new realities of compulsion and collectivism. This cultural contradiction is thoroughly analyzed by Hay from an outside perspective through an investigation of the development of medical liability insurance and its implications for tort law reform and health care provision in the USA. The book seeks to transcend traditional disciplinary boundaries to provide a straightforward account of circumstances giving rise to particular forms of legal, medical and social regulation in the USA through an inquiry into medical malpractice and health care costs in the ever-changing domestic and worldwide arena. It provides a comprehensive association of American medical liability issues, health care spending, and post-war national and international contexts. The book should prove of particular interest to scholars, students and doctors as it provides a framework for understanding legal and medical change associated with medical liability and its insurance.