In this book a physician long involved in health policy issues at the national level presents a wise, achievable vision for American health care. From his wide ranging professional experiences and his personal experiences with three life threatening illnesses, he charts a uniquely American “epidemiology of hope” that flows from the country’s vast medical research investments and technology transfer capabilities; challenges patients and health professionals alike to recognize a central decision making role for the patient on the healing team; and offers thought-provoking insights into physician-patient communication, the placebo effect, suffering, dealing with death and dying, and the nature of the social contract between those in the healing business and those seeking to be healed. Most important, after provocatively grading American health care from B-plus to D in relation to hope, mercy, justice, and autonomy, the book proposes a new metric, the Organizational Therapeutic Index (OTI), for assessing and improving our health care system.