Letter to the Editor

Arnold S. Relman says our current health care system is in critical condition ("The Health of Nations," March 7). Unfortunately, his article failed in both its diagnosis and its prescription. He critiques the deficiencies in our system but proposes a utopian solution that could never exist. Although his model has been attempted and is currently in place in Canada, he neglects to examine its real world results.

In Canada, my home country, patients must wait months for procedures that are available in days in the United States, thanks to Canada's single-payer system. It may save the government money, but it costs patients plenty in pain, suffering, and anguish. If Relman is correct and "uncontrollable costs are the primary problem in our present system," then his proposal to put a huge government bureaucracy in charge of collecting taxes and allocating resources is not the answer. The solution is to move away from third-party payers and toward more individual responsibility for health care. This is the real promise of consumer-directed health care arrangements and why they will, over time, be adopted and embraced by Americans and their employers.

Sally C. Pipes
President and CEO
Pacific Research Institute
San Francisco, California