Health care delivery in the United States has long been described as a "cottage industry" is characterized by fragmentation at the national, state, community, and practice levels. There is no single national authority or set of policies governing the health care system, states divide their duties among several agencies, while providers practicing in the same community and caring for the same patients often work independently of each other. In addition, the fragile system of primary health care is on the verge of collapse. This report is the Commonwealth Fund Commission on a high ...