Mark V. Pauly offers a detailed look at the individual insurance market in the United States. He explains how it works, suggests approaches to improvement that build on what currently works well, and provides a realistic assessment of how much improvement we can demand and expect. He concludes that, although there are some serious deficiencies in today's individual insurance market, there are also some important advantages in this market that should be preserved.

The debate rages on over how to cope with the rising costs of medical care—proposed solutions range from a single payer system with a broad government control to loosely defined market-driven plans. The authors look at three key elements of health care costs and offer thoughtful, realistic suggestions to help stem the tide of rising expenses for everyone.