Letter to the Editor

Your recent editorial on universal health care skirts some key realities ("Moral Imperative," March 20 & 27). The health systems in France and Japan are very different. France has more hospital beds per capita than the United States, but many states have "certificate of need" regulations that prevent new hospitals from being built unless newcomers can overcome incumbents' lobbying against competition. So increasing the number of hospital beds in the United States requires less government control, not more. And, in Japan, health insurance is provided by over 5,000 different plans; this competition leads to more effective investment in diagnosis and prevention. In the United States, competition between health insurers is also limited by states' mandates. In Canada, however, medically necessary physician and hospital services operate under a complete government monopoly and produce deadly waiting lists. Last year, Canada's Supreme Court determined that, in Quebec, this monopoly violated patients' civil rights.

Your editorial also cites questionable data about the number of uninsured in the United States. Although one 2004 Census Bureau survey (the Current Population Survey) puts it at just over 45 million, another series of surveys from the same agency (the Survey of Income and Program Participation) puts it at about half that estimate. Nor do you discuss how current government regulation needlessly increases prices of health insurance, physician and hospital services, and prescription drugs.

John R. Graham
Director, Health Care Studies
Pacific Research Institute
San Francisco, California