the dynamic health care environment edward o neil ph d mpa professor family and community medicine dental public director of center for professions university california san francisco http futurehealth ucsf edu outline where we came from current drivers change basic elements other challenges responses thanks to foundation endowment robert wood johnson pew charitable trusts gordon betty moore last update 9 26 05 a few beginning observations system is total mess no one person has true picture it my sense opinions but discussion most what passes as strategy just more effort game perspective or history today s legacy depression war prior resources little disposable income knowledge expectation disease self sufficiency ww ii created modern america economic growth post recovery dominance us rise middle class manufacturing service sector social man readjustment act rosie riveter civil
