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Medical care in the United States has been loudly and repeatedly derided as inferior in comparison to health care systems in much of the developed world and even in some relatively undeveloped nations. In Excellent Health offers an alternative view of the much maligned state of health care in America, challenging the statistics often cited as evidence that medical care in the United States is substandard and poor in value relative to that of other countries. Rather than relying on purely subjective judgments about equity and fairness, the book provides extensive, detailed evidence with which to answer the paramount question when considering quality of health care: “Where would you rather be when you are sick?”

Health care in the United States has made remarkable advances during the past forty years. Yet our health care system also has several well-known problems: high costs, significant numbers of people without insurance, and glaring gaps in quality and efficiency—and the Patient Protection and Affordable Care Act of 2010 is not the answer. This second edition of Healthy, Wealthy, and Wise details a better approach, offering fundamental reform alternatives centering on tax changes, insurance market changes, and redesigning Medicare and Medicaid.


In this book, Charles E. Phelps provides a comprehensive look at our health care system, including how the current system evolved, how the health care sector behaves, and a detailed analysis of "the good, the bad, and the ugly" parts of the system—from technological advances (the "good") to variations in treatment patterns (the "bad") to hidden costs and perverse incentives (the "ugly"). He shows that much of the cost of health care ultimately derives from our own lifestyle choices and, thus, that education may well be that the most powerful form of health reform we can envision.

Private health insurance in the United States protects most of the population against the risk of high medical care spending, but the extent of that protection has been declining for at least a decade. The reason for the decline appears to be no mystery: overall health insurance premiums for given coverage have been rising rapidly while consumer incomes have been near stagnant; consumers with little more to spend are increasingly reluctant to spend it on something with a rapidly growing price. But this simple story of prices growing relative to incomes is not quite right, and one piece of evidence arguing for a more nuanced approach is the well-known, widely varying susceptibility to this problem across the population.

A former U.S. Secretary of the Treasury and an eminent economist, both Hoover Institution fellows, tackle the biggest social issue of our time in the book Putting Our House in Order: A Guide to Social Security and Health Care Reform (W.W. Norton, 2008).