Youth and education in Philadelphia; residency at Montefiore Hospital [Montefiore] and its effects on his views; experiences in army: training camp and European tour; return to Montefiore: description of hospital's home care program, experiences working in Bronx neighborhoods, creation of Montefiore Medical Group, directorship and goals for Montefiore; conflict between social aims and financial con cerns for doctors; medical trends since World War II and effects on city hospitals; relationship of city and state in health care equation; effects of politics on health care; Edward I. Koch [Koch] administration and health care: progressive ideas for city's health care program, creation of Health and Hospital Corporation, financial limitations and other difficulties, Koch and the AIDS problem, affiliation program, working relationship with Koch; comments on Medical Advisory Board and Academy of Medicine, skepticism about political system's ability to provide a sufficient health care system; Koch administration's failure to fully realize potential of health care system economically.