no longer affordable. For a family of four, that would be over $30,000 when median household income is about $50,000. So an equitably financed system in the United States would also require a transfer from wealthier individuals to the majority of us. Libertarians and egalitarians will never agree on the appropriate course. All other nations tend toward an egalitarian approach. The World Health Report 2008, published by the World Health Organization, singles out the United States for its exceptionalism - a system with "singularly high additional private expenditure" that persistently underperforms "across domains of health outcomes, quality, access, efficiency and equity." Everyone should read this report. Very brief excerpts and a link to the full report can be found at: http://www.pnhp.org/news/2008/october/th\\... Won't competition be impeded by a universal health care system? Advocates of the "free market" approach to health care claim that competition will streamline the costs of health care and make it more efficient. What is overlooked is that past competitive activities in health care under a free market system have been wasteful and expensive, and are the major cause of rising costs. There are two main areas where competition exists in health care: among the providers and among the payers. When, for example, hospitals compete they often duplicate expensive equipment in order to corner more of the market for lucrative procedure-oriented care. This drives up overall medical costs to pay for the equipment and encourages overtreatment. They also waste money on advertising and marketing. The preferred scenario has