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With a greater demand for cost consciousness in the health-care delivery system, it is time to review what we expect to accomplish with intensive coronary care. This paper reviews the literature on the subject, attempts to determine the nature and function of the “system,” and tries to provide reasons for maintaining its existence or eliminating it altogether.The approach in this paper is objective, but not financially so. Funding to save lives is largely a matter of society's priorities, returning to the old question about how much a life is worth. Costs and priorities are so variable from place to place, this paper limits its coverage to “technical” aspects of the system.