<P>American hospitals are unique: a combination of public and private institutions that are at once charities and businesses, social welfare institutions and icons of U.S. science, wealth, and technical achievement. <I>In Sickness and in Wealth</I> helps us understand this huge and often contradictory "industry" and shows that throughout this century the voluntary not-for-profit hospitals have been profit-maximizing enterprises, even though they have viewed themselves as charities serving the community. Although our hospitals have provided the most advanced medical care for acutely sick and curable patients, they have been much less successful in meeting the needs of the chronically ill and the socially disadvantaged. That, Stevens concludes, is the next urgent task of social policy.</P>