The Paradox: Americans are not as healthy as people in dozens of comparable countries that spend 30 percent less on health care, and our medical marketplace overall is plagued by persistent problems of cost, quality, and access. Yet, the world's best individual health systems are located in the U.S.--each a unique result of visionary leadership and private initiative, not government-driven health reform.

The Imperatives: Due to powerful new forces explained in this book, medical spending has stopped growing. Purchasers, payers, and patients...