Despite decades of hand-wringing, the healthcare community hasn't found the political clout, the political will, or even the collective desire to wrestle the costs into control (Schaeffer, as chairman of Surgical Care Affiliates, one of the nation's largest surgical care companies, is part of that crowd.) In the meantime, a quicksand of greedy special interests, spineless pols, and, let's admit it, our own sense of entitlement has left America with some of the planet's highest per-capita health spending--$6,102 a person in 2004 versus an average of $2,552 for member countries of the Organization for Economic Cooperation and Development. What has this money bought? Not much. Schaeffer cites our "disturbing" international rankings on the accepted measures of healthcare performance.

As the author notes, alarm bells are now sounding in D.C. Indeed, in this month's New England Journal of Medicine, Congressional Budget Office boss Peter Orszag warns that we're breaking the bank, a message he's already put directly to Congress. On our current path, Orszag stresses, Medicare and Medicaid spending alone will suck up the equivalent of our current federal budget by 2050--that's 20 percent of GDP, for all you policy wonks.

That'll never happen, of course. But the healthcare industry's window for self-reform is closing fast, Schaeffer writes. Washington will soon start talking about healthcare in the language of national security, as in: Sorry pal, we just can't maintain our nuclear subs, fight the terrorists and pay for your liver surgery.

In a nutshell, he'd much rather the health lobby be in charge than the defense lobby. No surprise, given his job title. Then again, some of the patients at Walter Reed Army Medical Center would no doubt agree with him.