Prologue: While Washington's philosophical debate pitting the advocates of market principles against believers of government regulation simmers, Jeff Goldsmith argues that the realities of the American medical care system are quite different Indeed, Gold-smith says the industry is already in the throes of twin revolutions in the financing and delivery of care and public policymakers have played only a minor role thus far. Goldsmith, a nationally respected analyst of the health sphere, holds a Ph.D. in sociology from the University of Chicago. He is the author of a book entitled, Can Hospitals Survive? which was published in 1981. After completing his doctorate in 1973, Goldsmith spent two years working for Illinois' Republican governor at the time, Daniel Walker, as a budget analyst, an experience which he says proved “radicalizing.” Goldsmith came away from that stint with a belief that markets were a far better way to allocate resources than were governments. While his belief in markets is fervent, Goldsmith has a respect for the professional component of medicine that distinguishes him from some of the other members of this philosophical school. “Medicine is not a business, but there is a market for its services,” Goldsmith says, “and how management accommodates itself to physicians will tell alot about the future configuration of the system.” From 1975 to 1982, Goldsmith worked for the University of Chicago Medical Center, directing its health planning and regulatory affairs. Two years ago, he formed his own consulting firm, Health Futures, Inc., and also became allied with the accounting firm of Ernst & Whinney as its national technical advisor.