As easy as the book is to read, its analysis of the major ethical issues is ultimately unsatisfying. Arguments for and against the usual managed care interventions are offered as discussions among colleagues or as plot-line, a pleasant-enough presentation, but the commentary at the end of each chapter comes largely from business experts. The concerns of deciding how much (or even whether) to profit from health care services, how to balance limited resources under capitation against the individual needs of patients, and the role responsibilities of each clinician in deciding how and when to ration care are simply not addressed. The emphasis on business ethics is discouraging. A reliance on financial incentives to drive sound professional judgment is demeaning to health care professions who derive their mission from principles of beneficence and nonmaleficence.