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Health services have long been characterized by inequities and contradictions urban concentration of health resources versus a dearth of rural services and, within the urban situation, relatively efficient services f a few large institutions versus the conglomeration of small, inefficient, and largely autonomous units.

Using the Cuban system as a model, Danielson discusses the ingrredients involved in the transformation into an equitable medical sys-tem. The sociopolitical formation of new health workers, the continuous emphasis on rural and primary services, the involvement of all groups, including specialists, in the general fanning process, and a pragmatic style of politically inspired leadership t all levels of organizations are examined in this context. The author so considers the need for heavy economic investments and popular support for social reform as prerequi-sites for establishment of equitable medical services. According to Dan-ielson, medical and social revolution are closely linked.

Throughout his exposition, there is a rare quality of sympathy and com-passion for all the earnest and honest health reformers, physicians, andmedical faculty of Cuba, regardless of their political orientation.