The health care system in the United States is in chaos. The conflict is between containing costs on an aggregate level while, at the same time, not reducing services to the individual if the services are essential for quality care. There is little information on which to base decisions about the value of services. Health care organizations and delivery models must be restructured because current models are out of date. To accomplish this restructuring, better information is needed on why hospitals and doctors do what they do. Success in developing information and decision models that result in patients receiving only medically necessary services will contribute greatly to promoting high quality, cost-conscious care.