Critics from the traditional left argue that pluralism and devolution should be resisted because they produce rising inequalities, particularly where they are coupled to greater consumer choice. But a compelling case can be made to the effect that exactly the opposite is true. Supposedly uniform system turnout on inspection to be highly inequitable. In the UK, for example, which until now has one of the most centralized health care systems, performance data show clearly that the poorest people get the worst services – and the least choice or control over how they are provide. The better off have more choice, since they can opt out state-based provision.