Fifty years of attempts at reforming health care have failed. Not just failed to do what was promised, but actually made conditions worse than they were before. As a result we have a system that is extremely bureaucratic, inefficient, unaccountable, inconvenient, of questionable quality, and enormously expensive. We need to find a better way, and that involves putting the consumer/patient/taxpayer back in charge of their own resources and enables them to buy services according to their own sense of value.