A new report summarizes our woeful place in the world regarding health care performance. How is this possible and ethical in the wealthiest country in the history of the world? We have the highest per capita spending on health care in the world. Shouldn’t we expect the finest health care, by any measure? No matter how you feel about the recent political fight over health care in Washington, we should all be concerned that we are not getting the value we are paying for. Sadly, the odds of any political or societal will to promote actual, deep change are long. It may take a catastrophe of BP or Katrina proportions before we wake up and find real solutions to the health care crisis in this country.