STUART H. ALTMAN is the Sol C. Chaikin Professor of National Health Policy and chair, Council on the Economic Impact of Health System Change, Institute for Health Policy, Heller Graduate School, Brandeis University. He has held key health policy offices for Presidents Carter, Reagan, Bush, and Clinton. UWE E. REINHARDT is James Madison Professor of Political Economy, Princeton University. He is regularly quoted in the New York Times, Wall Street Journal, Health Affairs, and other publications. DAVID SHACTMAN is project director, Council on the Economic Impact of Health System Change, Institute for Health Policy, Heller Graduate School, Brandeis University.