Despite spending more for health care than any other country in the world, the U. S. has a health care system that compares poorly with other advanced countries in terms of access, cost, and quality of care. With so many Americans being unable to afford essential care, this problem has reached crisis proportions for much of our population. As a result, health care will continue to be a front burner issue in the forthcoming 2022 and 2024 election cycles. Today we have a corporatized medical-industrial complex that has resisted recurrent reform attempts over the years. It has become too big and complex for responsible government to rein in its excesses. The COVID-19 pandemic has further exposed its fragmentation and barriers to care. The traditional service ethic of health care has been replaced by profiteering of Wall Street corporate interests and investors seeking maximal profits vs the common good. Still controversial in this country is whether health care is a human right or a privilege based on ability to pay. Other advanced countries around the world have long since built their health care systems on the basis of universal coverage ensured by government. The future of health care depends on fundamental reform. It will require winning the battle between Wall Street/corporate America and Main Street that we cannot afford to lose. This book has three goals: (1) to bring historical perspective to how the medical-industrial complex has evolved to its present strangle-hold over health care comprising one-sixth of the nation's economy; (2) to describe the shortfalls of our supposed system in terms of access, cost, inequities, and unacceptable quality, and how past reform attempts have failed; and (3) to consider two major scenarios for reform, together with political forces for and against each and their projected outcomes. Since present trends are unsustainable, we can only hope for positive moves toward reform, as will be described.