Ten years ago, soaring health care costs prompted the Clinton administration to propose sweeping reforms to the health care system, including a substantial new role for the federal government. But the plan drafted under the guidance of First Lady Hillary Clinton was defeated in Congress. A decade later, the problems with our health care system seem to have only gotten worse. In the recent economic downturn, millions lost their insurance along with their jobs, adding to the estimated 40 to 45 million Americans who have no medical insurance at all. Meanwhile the costs incurred by government and businesses to keep the rest of us covered are skyrocketing. Has the HMO model of health care that became predominant in the 1990s failed us? If so, what should replace it?