Moderated by Mr. Murray, the panelists talked about the prospects for a market-based health care system in the U.S. Professor Enthoven said the employer-based health care insurance system is failing, that cost and quality of health care are out of control and have almost no accountability. He recommended a coordinated purchasing strategy that would create incentives for providers to innovate to improve quality and cut costs. The other three panelists, including Mr. Barton who represented the Business Roundtable, responded to Professor Enthoven’s presentation. Then audience members' questions were answered by the panelists.