Conversations host Harry Kreisler welcomes Stuart Altman for a discussion of the struggle to reform healthcare in the U.S. Altman traces his intellectual odyssey and recalls his long term involvement in national policymaking. In his reflections, he considers the successes and failures of reform in the context of U.S. political culture and history. Analyzing efforts by Presidents from Roosevelt to Obama, he highlights the twin goals of cost reduction and universal access. He concludes with an examination of the Obama plan speculating on the future of cost control. In his conclusion, he offers advice to students on how to prepare for the future.