Billions of dollars are now beginning to flow into the medical informatics market in hopes of achieving a breakthrough in healthcare delivery. The goals are noble and altruistic, but only the details will show the potential advantages as well as the limitations. Should we really spend huge sums of money to automate a system that has never functioned well on a national basis? Should we attempt a huge integrated system when we have no useful prototype to follow as a model? Can the government be trusted to be a benign dictator? …