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  DT1, thanks for your comment and the chance to answer - Much as I dislike the American system and flawed as it is, even with their commercialism their health care provision and treatments are second to none.
  
  I made the point about how competition should apply and directly excluded quality of care from that and suggested that the element of competition should be outside the key areas of care but in the 'add-ons'. If you look at policies in a range of different types of insurance products you actually see that now. I have just recommended a Group Income Protection Scheme and key differentials such as 'free cover' levels and support during ill-health with rehabiliative provision were key differentials. Such competition is actually healthy and can create much better products and services to clients. Incidentally the product that I ended up recommending had the highest free cover level and the best rehabilative services while the cost is only 0.98% of payroll, the lowest premium. The one that came second cost 1.34% of payroll. So there was very much a win - win situation for the employees of that company and the employer.... By the way, the beneftis are better than what someone would get from State benefits, higher, longer and are not subject to an 'all work' test after 12 months of disability. Better all round.
  
  As for the sale of hospitals. Once again I would suggest that range of providers in hospital care in competition for referrals can benefit the system by way of that competition (on costs/treatment quality/accomodation quality etc). Not all need be commercial 'for profit' either, providers could be charities/mutuals etc as well as commercial operators. Again I would suggest a multiplicity of options can be highly beneficial. I personally see no problem of commercial operators providing these services for profit after all the great leaps forward in treatment and drugs development are made primarily by commercial companies out for profit. There is absolutely nothing worng with it as long as there are high standards and good results.
  
  I believe that the greatest problems arise from a lack of choice and a lack of competition from monopoly providers whether state providers or commercial providers.

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