Mark V. Pauly offers a detailed look at the individual insurance market in the United States. He explains how it works, suggests approaches to improvement that build on what currently works well, and provides a realistic assessment of how much improvement we can demand and expect. He concludes that, although there are some serious deficiencies in today''s individual insurance market, there are also some important advantages in this market that should be preserved.

Mark V. Pauly is the Bendheim Professor in the Department of Health Care Systems at the Wharton School of the University of Pennsylvania.