The physician's estimate of prognosis under alternative treatment plans is a principal factor in therapeutic decision making. Current methods of reporting prognosis, which include five-year survivals, survival curves, and quality-adjusted life expectancy, are crude estimates of natural history. In this paper we describe a general-purpose model of medical prognosis based on the Markov process and show how this simple mathematical tool may be used to generate detailed and accurate assessments of life expectancy and health status.