Alas, however, it does little more than that. The text seems often to stop at description of problems. This lack of critical commentary contrasts with the liveliness of highlighted quotes set apart from the main body of the text, which derive from public workshops the Institute of Medicine gave around the United States. For example, Margaret O’Kane of the National Committee for Quality Assurance, a group unknown to me, is quoted as saying, "We know that there is competition in the health care marketplace today. I don’t think anybody doubts that. But it is very much a price-driven competition. And that, we think, is very dangerous to the quality of care that patients are receiving" (p. 31). Like most of the quotes, this one would be a nice departure for debate—I for one agree with it—but the text neither takes a real position nor elaborates a debate.