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

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