The purpose of the course is to help the new generation of health professionals understand the environment within which they will practice. This health system in the U.S. is under extreme stress, and the organizations of health care, the conditions of practice, and the competitive environment will all be changing in response to those pressures. This course is about those institutions, those pressures, and those changes we may expect. The main objective here is to make each graduate of our health professional programs a knowledgeable and articulate analyst of the performance of, and challenges facing, the U.S. health care system.