Improving Health Care: A Dose of Competition (2004), a Federal Trade Commission and Department of Justice report, argues for increased competition in the health care sector and among health care providers. This article considers some of the recommendations made in the report, in particular, whether competition in medical markets is effective in bringing about efficiencies and if indigent populations are likely to benefit from such a policy. The author examines the prohibitive cost of expanding the public program to cover most uninsured people, a policy that would necessitate significantly more government involvement in the health care system. The report supports eliminating benefit mandates, thereby providing consumers with the ability to decide what coverage they require considering their individual health circumstances. However, this author suggests that collective decision-making may be a more effective way of ensuring comprehensive choices for everyone. One outcome of a competitive health care system is to create a multitiered quality of care with poor care for poor people, though many low-income people may welcome basic health care services offered at lower prices that will at least provide them some access.