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In 1991, Bill George, CEO of Medtronic, the world's largest manufacturer of pacemakers, was evaluating his strategic options in light of the changing economic environment. In the United States, Europe, and Japan, governments were considering regulatory changes to reduce health care expenditures, including reduction in pacemaker prices. The case outlines Medtronics development of the cardiac pacemaker and its diversified businesses. It then examines Medtronic's pacemaker operations and the changing health care environment in the United States, Europe, and Japan.

Focuses on the origins of economic decline and the problems of economic management in Great Britain, the oldest industrial state. Reviews the formation of macroeconomic policy, welfare policy, and industrial policy in the postwar period. Examines Prime Minister Margaret Thatcher's diagnosis of Britain's ills and explores the effectiveness of her cure.