Introduction: What is "The Case," and Why is It Managed?

Forged in response to social problems of human suffering, poverty, and distress, America's systems of health care and social welfare have themselves become social problems. Reforming those systems has led the domestic policy agenda and dominated front-page headlines throughout the past decade. National opinion polls in the 1990s found more Americans naming health care as the most important problem facing the country, save crime and violence, while the issue of welfare topped taxes, the environment, the trade deficit, and the international situation as an area of primary concern (Gallup, 1994). At its core, the public's sense of the problem is that these systems are out of control and we are paying for it, individually and collectively, with our money, our well-being, and even our lives.