The first obligation of the editor is to convey to the reader the reasons for undertaking this collaborative effort and the purposes that it aims to serve. I shall speak to each in turn. The book aims specifically to contribute to the debate on health reform that dominates the political arena in 1994. For the better part of three decades since the passage of Medicare and Medicaid, neither the public nor the Congress paid serious attention to issues of cost, effectiveness, and equity in the financing and delivery of medical services to the American people. However, once the presidential campaign of 1992 got underway and once President Clinton entered the White House, health care reform moved rapidly toward the top of the domestic political agenda. Since many aspects of health care reform have been little studied and less understood, a volume directed to illuminating many of the critical dimensions of the prospective reforms was an inviting challenge, one that has engaged the authors and the editor, with due acknowledgment to The Commonwealth Fund for its interest and support.