Every economic institution finds itself caught on the horns of a dilemma: Competing sets of values strike a conflict between social good and economic wealth, regardless of whether organizations articulate it. The struggle in U.S. health care, however, is both more acute and poignant. On the one hand, ethical and cultural values require societal commitments to the well-being of the individual. Who among us would want to refuse help to someone sick or injured? On the other hand, market forces require an economic accounting of health care. Social trends emphasize a mission to provide care for all, while managed care promotes the industry's fidelity to a balanced ledger. U.S. health care is thus defined by paradox. The nation spends more than $1.3 trillion annually on health care--a national line-item larger than the economies of all other nations except two (Germany and Japan). A new study by the Health Care Financing Administration warns that health care spending may nearly double to $2.1 trillion by 2007. Yet the industry is perceived to be too "resource-constrained" to assure health care services for all citizens. This poses a key question: Are there too few resources, or are we simply not allocating them in the best ways possible? Health care's "double bottom line"--social and economic accountability--typifies the social and economic milieu of health care as the final pages turn on the 20th Century. And, it is this duality that forms the underlying theme for the landmark study--Leadership for a Healthy 21st Century--conducted over the course of the past year by Arthur Andersen and The Healthcare Forum Foundation, with primary research support from DYG, Inc. and Baruch Lev, professor at the Stern School of Business, New York University. The study was designed to investigate a new economic model emerging in the information economy and its impact on health care; the evolving values of consumers in relation to business, health and health care; and the values of corporate leaders in health care and other industries. The overall objective: development of a 21st Century leadership model in health care capable of resolving the conflicts inherent in serving two masters: (1) compassion and (2) wealth and value creation.