Teaser: How do we avoid a culture of contentment so that we don’t make the changes we need. In this great book, world-leading health economist Cam Donaldson defends NHS-type systems on the same basis as their detractors: economic efficiency. However, protecting government funding of health care is not enough: scarcity has to be managed. Donaldson goes on to show how we can get more out of our systems by addressing issues of value for money. In particular, he demonstrates what has been achieved through health care reform but questions how much more this can deliver relative to getting serious about priority setting.