It is Time for Universal Access, Not Universal Insurance

An editorial by Relman proclaims, "Universal Health Insurance: Its Time Has Come."1 Other recent Journal articles recommend various consumerchoice health care systems,2 , 3 and the report of the National Leadership Commission on Health Care proposes what is essentially a national health insurance scheme.4 I submit, instead, that the idea whose time has come is universal access to care — not through universal insurance that is funded from a central source or tightly controlled by forces other than medical need, but through a pluralistic delivery system.Universal health insurance is not a good idea. To control goods or services through a single . . .