Despite the visible growth of for-profit chains in recent years, most Americans receive their inpatient care in voluntary, nonprofit hospitals. About 60 percent of our hospitals are nonprofit; they contain 70 percent of all acute care beds. These institutions are beleaguered and fearful. They are attacked by free-market advocates as flabby, poorly managed, and unimaginative in comparison with the for-profit sector. Advocates of more equitable access complain that they fail to provide enough free care to uninsured citizens. Public and private groups that pay for most hospital care decry high costs.