John R. Graham, director of health care studies at San Francisco think tank Pacific Research Institute, views health care reform from the perspective of a free market advocate.

Before coming to California in 2005, Graham directed Health and Pharmaceutical Policy Research at the Fraser Institute in Vancouver and wrote papers on prescription drug regulation, public drug benefit programs, and the "re-importation" of prescription drugs from Canada into the U.S.

Graham writes frequently on health care and spoke with reporter Sara Solovitch about the case California's proposals to revamp its health care system.

Q: You overturn the very paradigm about health insurance and say it's not the insured but the uninsured who are subsidizing our health costs. What are you talking about?

A: If you look at who's becoming uninsured, every year it's people with a slightly higher income, people who are making $'70,000 and not getting insurance. Something is screwed up with insurance, not health care.

Governor Schwarzenegger has focused his whole plan around the issue of the uninsured using hospital emergency rooms. But if you look at national spending figures, on]y 4 percent of health expenditure is uncompensated.

He points to the hidden tax from uncompensated care and says that it costs $9.1 billion. Yet his solution costs $12.1 billion. Right away, he should stop and say, 'Wait a minute..'

Q: As a Canadian who studies health insurance, how do you respond when Americans say, "We need what you have"?

A: Whenever I talk to an American doctor who says that, I say "why," and he says "So I don't have to have 14 employees sitting in my office doing nothing but deal with different insurance companies all day." Oh yeah. I tell him, it would be easier for three or four years and then just wait.

The Canadian health care system is like the Soviet bread line: You queue for health care. The average waiting time from when you see a general practitioner to a surgeon is 18 weeks. Things like MRIs and CAT scans, people in Canada say, what's that?

What (State Sen.) Sheila Kuehl CDsanta Monica) wants for California - universal health insurance - would be disastrous. Private health insurance system in this country is already a basket case. What's needed is less government intervention, not more; more competition. not less.

Q: You've written favorably of the Swiss system. What makes it so good?

A: It's not perfect, But there's one thing that's exciting: you keep the same insurance plan your whole life. So the f1rm that's offering you a plan when you're in your 20s has an incentive to give you the right preventive care.

Also, in Switzerland, you don't have to get health care insurance through your employer; you can get it through your union or your church. We have to de-link the job from health insurance. I don't know why people find this such a challenging idea. Imagine if your fire and theft insurance was linked to your employer. That makes about as much sense as health insurance.

Q: A famous study from Harvard found that half of all personal bankruptcies in the U.8. are caused by soaring medical bills, and that in many cases, the people actually had health insurance at the onset of their illness.

A: That study was criticised for a number of things, though I think there's some truth in it. The price of doctors is too high because we're paying for their medical malpractice premiums. The same can be said for medical device and prescription drug makers: there's a cost built into their prices for product tort liability.

Some supply side reforms have to happen. The cost of regulation in health care is massive. Christopher Conover [assistant research professor of public policy studies] at Duke Universijy wrote a paper in which he said that the cost of overregulation in health care is so expensive it's killing people. He says it kills 22,000 people a year, compared to the 18,000 who die from being uninsured.