This document discusses how a nonprofit hospital named Memorial Hermann has changed since the 1980s due to economic and political forces. It analyzes three significant changes: the adoption of new technologies like electronic health records; recruiting highly qualified medical professionals; and responding to demographic changes like an aging population with more chronic diseases. While these changes have positively impacted the hospital's efficacy by improving patient care and increasing revenue, they have also negatively impacted the U.S. health system overall by increasing costs and reducing affordability and accessibility of healthcare for many patients.