The United States has the most expensive healthcare system in the world. Why is this so? What can we do about it? In this lecture, Professor Michael Sparer compares the cost of care in the U.S. to other high-income nations and examines why we are such an outlier. He also examines a range of policy proposals that are designed to slow the cost growth. How would such proposals impact patients, providers, and other participants in our complicated and confusing health care system? Must we always check our checkbook before seeking medical care? Can we have a healthcare system that provides high quality care to all at an affordable price?