Institutions that perform health care have become untouchable, especially for the poor. Therefore, the capability of achieving an optimal degree of community health is still far from hope. There are many factors that contribute to this condition. This essai describe the main ideas and strategic issues which need to be understood in order to enhance the performance of these institutions. The description in this essai will cover structural relationships between the doctor and patient, capital monopoly, the degrading professional ethic of physicians, and the quality service of hospitals as a service industry.