Havighurst adds a very needed point of view to the debate about health care delivery in the United States, particularly in light of the debate surrounding the Patient Protection Act. Havighurst explains that the biggest factor contributing to problems in health care financing rests in the fact that the financing structure of employee-based insurance de-couples consumption of services from cost.

In addition, the dominance of health care by the medical profession's vague and subjective standards regarding medical necessity, along with the American myth of health care as a right, sets up a system in which cost is not taken into account when making treatment decisions. The Congressional Budget Office estimates that the Patients Bill of Rights will cause a 4.2 percent increase in insurance premiums, about 1.7 percent of which will be "passed through" to workers in the form of less taxable income. This will result in a loss of about $22 billion in Social Security taxes over the next nine years, further straining an already weak program. The rest of the increase will cause a decrease in benefits, employers dropping coverage, and higher employee costs.

Havighurst's book outlines how innovative health care contracts can be structured to provide varied levels of coverage and pricing in order to allow real choice in benefits and costs, rather than letting the federal government dictate the degree of insurance one must purchase.

Clark C. Havighurst is the William Neal Reynolds Professor of Law at Duke University.