Michael D. Tanner, director of health and welfare studies, and Michael F. Cannon, director of policy studies, are co-authors of Health Competition: What’s Holding Back Health Care and How to Free It.

The authors put forth the argument that universal health care is not the answer because it misrepresents what it is and who it helps. Simply, they feel that politicians and the American public fail to understand that there is a gap between universal health coverage and the actual access available to medical care.

They point out that universal health care supporters fear that those who are in need of health care will be denied the care they need. What they claim is overlooked by universal health care promoters is that health care systems, like that in England, have long waiting lists for things like hip replacement. They claim in some cases it can take up to a year.

From this writer’s viewpoint their argument is specious. Yes, there are sometimes long waiting periods for operations like hip replacement, but isn’t it better to wait for a hip replacement than not being able to afford one? Of course, a patient requiring a hip replacement always has the option of having the surgery performed privately.

Another point the authors make is that under the current system health insurance is high in the U.S. because many young people forgo purchasing health insurance, which increases the cost of the premiums for those that do buy it. Their solution is a free market where companies can charge more to cover people who are likely to need more care. For example, the elderly, smokers, and those with likely hereditary factors should be charged more—in their opinion.

This writer thinks that they may have missed the point of insurance. Insurance is a way to spread the cost out among many so that those with the most need have access to medical care. It seems what they are really proposing is that those who have the greatest need, or likely to have the greatest need, for health care pay substantially more than those who are unlikely to need health care in the near future. Do we really want health care operating on a free market?