American healthcare reflects four deeply-ingrained American characteristics: it is individualistic, technology-driven, death-denying, and wasteful. These characteristics make "reforming" American healthcare extremely contentious. No medical technology is as emblematic of American healthcare and culture as the artificial heart. An exploration of its 40 year history (including its alternatives: death, organ transplantation, and tissue regeneration) as reflected in American medicine, public health, law, bioethics, human rights, bioengineering, and economics helps explain both how the American "NONsystem" of healthcare works and why it is so difficult to change.

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