Is the Canadian health care system becoming a victim of its own success? It has done what it set out to do – provide universal access to all medically necessary health services without financial barriers to patients – but expanding technology, an aging population, and escalating costs strain its ability to continue. It is time to explore ways to reorient and restructure the health care system and the services it provides. At the Fourth Canadian Conference on Health Economics, contributors of international reputation addressed these concerns. Their papers, collected in this volume, consider a wide range of fundamental issues related to health care policies and structures. They discuss new developments in health care delivery, assess implications of such new policies as home care and health promotion, and propose concrete alternatives for restructuring the present system to sustain universal medicine.