Since the historieal conference held in Alma Ata in 1978, it has been possible to observe a reorientation of the medical profession. More and more, issues of health enter the stage and curative medicine is not just loosing ground but some interest. 'How effective is health education?' and 'Whose task is primary pre vention?' are questions which stimulate great concern and public debate. It seems also to be the first time since the last decades of the 19th century that the social dimension of health receives adequate consideration. Thus the reeent publication of the so-called Black Report on Inequalities in Health (Penguin 1982) led to a heated discussion in Great Britain, certainly of relevance to many other countries. The 6 years since 1978 are much too short a time to proceed far towards 'Health for All', as the slogan of the World Health Organization puts it, but the concepts are spelled out, vaguely but convincing to many of us. It is the right time to discuss first experiences and to move from philosophy to empiri eal work. This work - as it relates to the process evolving since Alma Ata - is characterized by participation, cooperation and prevention: Participation, because 'disease' concerns only the individual patient, his or her family and immediate social environment, while 'health' concerns everyone and should involve everyone. It is a task of the whole of society rather than the domaine of a single profession or party."

One of the main purposes of medical cost-benefit analyses is to define the rational priorities in health care. This book ambitiously undertakes to compare the cost-benefit analyses of three countries: the United States, Germany and Israel. Cardiovascular disease is focused on to provide a model case study, but other areas also provide examples. The contribu- tions consider in particular two recent developments. These are the increase in comprehensive epidemiological data, es- pecially with regards to risk factors, and improved methodo- logy for measuring the quality of life. The contributions stem from clinicians, epidemiologists and health economists who give an overall picture of these complex issues and the prospects for the future.