IN 1971 Martin Feldstein published an article in this journal entitled “A New Approach to National Health Insurance.” In it, Feldstein proposed that the government provide every household with major risk health insurance (MRI). Under MRI, every household would have an income-related ceiling on its annual medical financial burden; MRI would thus achieve universal income-related catastrophic protection. At the same time, prior to reaching its out-of-pocket ceiling, every household would pay at least a fraction of any medical bill, so each consumer of medical care would have an incentive to be cost-conscious.