Summary :
The hospital has a paradoxical place in U.S. society.1 It is central to the nation’s economy, yet many of us are uncomfortable with what is implied by a market for hospital care. The hospital remains a last resort for the poor and desperately sick. It is a place where most of us were born and most of us will die. And it is a place to which we often turn in our moments of greatest physical uncertainty and emotional vulnerability. We have intimate connections to hospitals and strong feelings about them. Perhaps as a result of our ambivalence about the market for hospital care, the vast amount of money that changes hands as a result of this care rarely changes hands within the hospital itself.2 As the hospital historian Rosemary Stevens observes, hospital organizations continue to “carry the burden of unresolved, perhaps unresolvable contradictions.”3 Such contradictions, between the mission of hospital care and the market for it, are the focus of this book.

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