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To the Editor: In his review of my book "Our Parents, Ourselves: How American Health Care Imperils Middle Age and Beyond," Dr Fillit¹ describes it as factual and well researched but lacking impartial discussion. My viewpoint certainly conflicts with the implications of his review that our health care system is fine, the pharmaceutical industry benevolent, and old age evermore golden.

A majority of Americans receive, on average, only 40% to 50% of standard care.² Managed care has disrupted patient-physician relationships as people shuffle between insurance plans. The rising number of Americans unable to afford any insurance reflects a particular threat for middle-aged persons.³ Individuals may wait hours in an emergency department already overwhelmed by other uninsured and insured patients. Unemployed middle-aged persons do not easily find jobs that include health insurance; individual coverage may either be unaffordable or unobtainable owing to preexisting conditions.

Fillit criticizes inadequate mention of pharmaceutical contributions . . . [Full Text of this Article]

Judith Steinberg Turiel, EdD
jsturiel@hotmail.com
Berkeley, Calif

RELATED LETTER

"Our Parents, Ourselves"—Reply
Howard Fillit
JAMA. 2006;296(17):2093.
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Our Parents, Ourselves: How American Health Care Imperils Middle Age and Beyond
Howard Fillit
JAMA. 2006;295(8):941-942.
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