THIS BOOK GREW out of a puzzle: why is competition failing in health care? Throughout the economy, competition among private-sector rivals is the most powerful force yet discovered for driving improvements in the quality and cost of products and services. This is illustrated every day in countless industries around the globe.

How could the U.S. health care system, which is largely a private system and characterized by arguably more competition than any other health care system in the world, be performing so poorly? Why are U.S. costs among the highest in the world even though many citizens do not have health coverage? How could costs, already so high, still be rising so rapidly? Why is quality so uneven? Why is there growing evidence ...

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