Book excerpt: In the fall of 2004, President Bush reiterated U.S. support for crating an independent Palestinian state and called for the establishment of such a state within five years. While the prospect of an independent Palestinian state remains uncertain, the Palestinian Authority, the government of Israel, the United States, Russia, the European Union, and the United Nations all officially support establishing such a state. This study examines options for strengthening the health system of a future independent Palestinian state. Successful development of the Palestinian health system is worthwhile in its own right, and it may be a relatively cost-effective way to help demonstrate the tangible benefits of independence and peaceful relations with neighboring countries. Moreover, many of the strategies described in this volume can be implemented prior to independence, with the goal of improving the health status and health care services of Palestinians. As one component of a broader RAND analysis of options for structuring the institutions of a potential future Palestinian state (see the full report on previous page), this study should be of interest to Palestinians, Israelis, the international community, and organizations and individuals committed to strengthening health and health care for Palestinians.