A term without a clear definition, which is applied to the efforts on the federal, state, and local levels to make changes in the health care delivery “system” so that (1) costs are reduced or “contained,” (2) the uninsured population, estimated at 35-40 million people nationally, are covered; (3) all citizens have access to health care, (4) financing is assured, and (5) quality of care is controlled or, preferably, improved. The options as to “management” of the health care system range from highly centralized, federal controls, through the setting of certain requirements at the federal or state level but allowing local innovation as to implementation, through local solutions even if nothing is done at the state or national level.