The high cost of health care in the U.S. imposes an increasing burden on households, businesses, government, and our country’s economy – a burden made heavier by the current economic crisis. The money that insurance companies spend on inefficient administration, billing and marketing – instead of medical care for their enrollees – contributes to the high health care costs Americans must endure. To incentive efficiency and get costs under control, the U.S. should require health plans and insurers to spend at least 85 percent of revenue on health care. Almost half of the nation’s health plans and insurers we surveyed already meet this efficiency standard, while a similar number could comply with the standard with only moderate effort.