The healthcare system in the United States is undergoing significant change. The advent and widespread adoption of managed care has completely changed how health treatments are paid for. Rapid advances in technology and pharmacology have contributed to rising health care costs. While employed persons are still reasonably sure of having access to care, the poor and unemployed are not so lucky. The public health and mental health infrastructure is completely in crisis and no relief seems nearby. These significant changes in how health care is delivered have made life difficult for all.