Get government out of the way.

In the recent Point/Counterpoint column, both Dr. Kevin Grumbach and Robert Moffit, Ph.D., are off the mark ("What is the best way to reform the U.S. health care system?" February 2007, p. 10).

The recommendation by Dr. Grumbach to apply the single-payer method (a la Canada or the United Kingdom) is outrageous in the extreme, and would predictably result in the highly unsatisfactory situation seen in Canada, where long waits for what we consider to be routine procedures are the norm.

However, even Dr. Moffit's proposal is inadequate. Simply tinkering with this or that aspect, such as tax credits, special accounts, extra Medicare programs, and so on, will not fix the root cause of our problems.

There is a perceived problem with health care in this nation because many people find it excessively expensive. Why is it expensive? Most of us would like to think it's because of the costs of training, research and development, technology and equipment, etc. Some of us will hint darkly at the costs of "defensive medicine." A few will admit that "gaming the system" out of greed also is a factor. All of these may contribute, but they are not the root cause.

The root cause is government regulation. We have not had a free market in health care since the 1920s. From that decade onward, the states have told their citizens whom they could patronize for their medical care, by way of the Medical Practice Acts, put in place in response to the Flexner Report. Till then, any citizen could pay for medical care from anyone who was willing to provide it.

The federal government then got into the act in the form of the Food and Drug Administration. Until the FDA was established, any citizen could make and sell any medicine to any other citizen. Now, only the favored few who are willing and able (to the tune of millions and billions of dollars) to jump through the FDA's hoops are allowed to make and sell medicine.

Abolish these twin pillars of expensive medical care, and medical prices will drop like a rock, as availability skyrockets. Will doctors and pharmaceutical companies squeal as we see our incomes cut in half? Sure we will. And we'll couch our squeals in pious tones about protecting the patient from unscrupulous and unsafe practitioners and companies.

It is not the business of government to protect people from their own ignorance. Granted, because of some regulations, people have been kept from patronizing incompetent physicians or taking unsafe drugs. But the cost of such regulations outweighs the good, and it is unjust to force some to pay to protect others. Every day I see people who cannot afford the medicines or specialty care I think they need. The single-payer system would alleviate only a small portion of that, at the cost of greatly reducing the care received by everyone else. The universal health care tax, and other tinkering with the system, would only help small portions as well.

Get government out of medicine altogether. Trust the people to decide for themselves who will provide them with their medical care. Some may make unwise choices, but more will choose wisely, from a much richer and diverse array of products, providers, and services. This will result in much lower health care costs and better outcomes.

Jeremy Klein, M.D.

Louisa, Ky.