Abstract
A strong case for comprehensive reform of the U.S. health care system has been made many times. The high cost of care, the large number of uninsured people, and the rapid increase in expenditures year after year have convinced many that our system is a mess. The obstacles to reform, however, are numerous and complex and have thus far proved insurmountable. The present impasse must give way to recognition that major change will not be an option much longer: it will be a necessity. Divergent interests and values must find some common ground, and all sides must acknowledge that the status quo is no longer sustainable, given three “inconvenient truths” about health care.

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