Critics of the US Health Care System often find fault with its top heavy specialist and tertiary care orientation and lack of organizational coherence. Analysis of health care in the US over the past half century abound with such descriptions as a nonsystem with millions of independent, uncoordinated, with separately motivated moving parts. Some often describe our current system as fragmented, chaotic, and one that is impacted by uncontrolled growth. Describe your own thoughts about these observations and whether you think the high cost of health care has been attributed in part to this organizational disarray?