View the full text and press release.

The 1990s saw no progress in the financing of health care. About 40 million Americans still have no health insurance--including 22 percent of America's children and 19 percent of young adults. And an economic downturn brings with it increased numbers of uninsured.

What can be done? Mark V. Pauly and John S. Hoff answer with a tax credit/voucher system introduced in a common-sense way, with as much simplicity and flexibility as possible. The United States can launch such a program immediately and make needed adjustments along the way. The use of the credit assists people in obtaining insurance and provides tax equity.

The authors chronicle changes in U.S. attitudes about health care and in the economic environment, tackle design issues, and consider policy trade-offs and problems of the technicalities of such a program. They offer a sample tax-credit plan and respond to possible objections to their plan.

Mark V. Pauly is professor of health care systems, insurance and risk management, and public policy and managamement at the Wharton School of Business; professor of economics at the School of Arts and Sciences; and Bendheim Professor, University of Pennsylvania. He is a member of the Institute of Medince and an adjunct scholar of AEI. John S. Hoff is a health care lawyer and policy analyst in Washington, D.C.