In this unique issue, the content is devoted to the socioeconomics of healthcare. Healthcare economics provide the underpinning of urologic practice for today and tomorrow. All of our clinical endeavors are dependent on the economic realties of the twenty-first century. This issue elucidates some of the challenges that are facing patients, physicians, and society. There are two major sections, The Healthcare Landscape: The Big Picture and Urologic Practice: Current Issues and Future Prospects. In the first section, articles address the history and demographics of healthcare and following this, several authors provide different proposals for healthcare reform. These proposals are followed by more parochial urologic issues which include residency training, certification and recertification, urologic research, practice management, and the impact of medical malpractice.