Fred Bannister, M.D., is a newly retired physician with a unique history, having begun his practice in a town in Wisconsin as a single, independent medical practitioner, later adding large clinic and HMO management to his regular work in family practice. The trajectory of his 40-year career shadows the troublesome evolution of health care in America during the latter half of the twentieth century. With luck, the end of Bannister's career, in which he took charge of his own solo housecall practice, reflects better days that lie ahead for all of us.

The story of how Dr. Bannister built his practice with the help of partners during the 1960s and 1970s describes an idyllic time for doctor and patient. The next 20 years proved more complex. The decisions he and his partners made as they waded into managed care are like the decisions made—knowingly or unknowingly—by most physicians in America.

Bannister and his partners spent the next two decades as part of an enormous network of clinics under the umbrella of the world-class Mayo Health System. He also spent several years on the board of directors of his clinic network—six of those years as its treasurer—and had a hand in the formation of its HMO, the Midelfort Clinic Health Plan.

An experienced insider turned apostate, Dr. Bannister lays bare the poor fit between medicine and moneymen. Managed care, large clinic systems and corporate laws have debased the medical distribution system we have today. Health care in America is gravely ill.

Health Security America is the remedy.

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