There are few issues on the American agenda that affect as many people as health care and about which so little is being done. Whether access to care for the uninsured or prescription drugs for the elderly, there is a sense of urgency among the populace, and also a sense of futility. The u. S. health care system is so vast and complex even the most visionary of our leaders struggle to embrace its full breadth and scope. Reform efforts initiated by political leaders and industry professionals rarely look at the health care system as an integral whole. Reformers, guided by their own political agendas and vested interests, focus instead on symptoms and offer remedies that stretch the system into new shapes and propose regulations that restrict and complicate it. The pervasive power of special interest groups also contributes as meaningful reforms are so diluted they become meaningless. The health care system in place today is unacceptable and the evidence of a need for dramatic change is compelling. At home or at our jobs, we will fiddle with a tool or process for only so long before we conclude there must be a better way. We then step back to re-examine our purpose and we construct a new tool, one designed to serve our specific objectives. Radical Surgery leads the reader through a comparable process and offers a new vision of the American health care system, one that draws upon the author's experience as a medical group manager, as a director of a 500-bed, long-term care facility, and as a leader and problem solver in both the public and private sectors. The outcome is a National Health Care Plan that: provides comprehensive care and prescription drugs to all American citizens, gives the patient free choice of physician, enables doctors to practice quality medicine without interference of public or private bureaucrats, reduces aggregate health care expenditures by $200 billion per year, relies on free market forces to ensure quality, internal to the process, obviating the need for the health insurance and managed care industries, and eliminates Medicare and Medicaid and limits the role of government to the few things governments do well.