Can we rely on the altruism of professionals or the public service ethos to deliver good quality health and education services? How should patients, parents and pupils behave - as grateful recipients or active consumers? The book provides new answers to these questions, and evaluates recent government policies in health services, education, social security and taxation, and puts forward proposals for policy reform: universal capital or 'demogrants', discriminating vouchers, matching grants for pensions and for long-term care and hypothecated taxes.