It appears that “universal health care” has become conflated with “single payer.” The Netherlands, France and Switzerland all have universal health care systems with multiple payers, as efficient as the single-payer systems.

Why do I not support single payer? For the same reason I would not support a single source for automobiles, cellphones, or golf balls. If you don’t like what the single provider is providing, you have nowhere else to go. You are stuck with a government monopoly. Competition has proved the best method for improving quality, controlling cost and providing choice. I particularly like the French system, which uses nonprofit co-ops to put a lid on what private insurers can charge.

Why discard the benefits of quality and price competition, and choice, for health care? Consider our federal government: Is this what you want controlling your only source of health insurance? It would be a government monopoly, with nowhere else to turn. I would much prefer a competitive health insurance market, such as those of the Netherlands, France and Switzerland, which deliver universal care efficiently and with choice. And the French system is market based; the Republicans should love it!

If you prefer to have a government option, that could be added to the mix, with competition to ensure that the government doesn’t go off the rails. Or to give us alternatives if it does.

Brooke Jennings, M.D.