Health Care Competition? - NYTimes.com A May 31 news article reported that the Obama administration is chanting the mantra "competition in health care." Before it beats the drums too loudly, the country would do well to look at the record of competition in health care. We have had competition in varied forms for more than 40 years. The results include runaway costs, a struggle to hold overhead to one of five premium dollars, a nightmare of rules and regulations, and complex insurance forms that only a skilled expert can understand. Competition has also spurred every provider to have the best and latest in equipment. Once in place, these heavy, fixed-cost devices must be used. Competition is the spur that drives unnecessary tests and procedures. It is unwise to champion a public policy that has failed for 40 years. The writer is professor emeritus of social medicine at the University of North Carolina, Chapel Hill.