HEALTH CARE is often touted as yet another sign of American exceptionalism. While the Canadians and the British provide “universal” care through government-run systems, it is said, the U.S. depends on free markets. In reality, the American health-care market has been heavily distorted by public policies. As the late Milton Friedman observed, “Most payments to physicians or hospitals or other caregivers for medical care are made not by the patient but by a third party–an insurance company or employer or governmental body.” Whatever its many faults, the U.S. system does not suffer from an over-reliance on free markets.

To be sure, it is more market-friendly than the health regimes in Canada and Britain. But the U.S. also maintains a variety of federal and state programs-such as Medicare, Medicaid, and the State Children’s Health Insurance Program (S-Chip)-to insure the elderly, the poor, lower-income children, and others. So the question is not whether Washington should introduce government management of health care, but whether it should expand government management of health care.