A Dose of Reality

Assessing the Federal Trade Commission/Department of Justice Report in an Uninsured, Underserved, and Vulnerable Population Context

The Federal Trade Commission/Department of Justice report on the role of competition in the health care industry, Improving Health Care: A Dose of Competition (2004), pays scant attention to the nearly 46 million persons without health care coverage, according to this article. Its analysis is geared toward well-off, educated consumers who are equipped to make health care choices. Furthermore, the authors state the report neglects the legal context for health care access. For instance, the fact that there is no legal right to health care in the United States and few restraints are placed on the health care industry's ability to choose its customers and tailor products to attractive market segments. In stressing the positive role of competition in health care, the report also downplays the health care access problem. It fails to explore barriers to access beyond the issue of insurance coverage. The authors also indicate that one of the most unsettling aspects of the report is its failure to consider the impact of the insurance problem on specific subpopulations or to mention the disproportionate representation of minority groups among the uninsured.