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In Reply: We agree with Dr Hubbard that the public would benefit from such education. In the table of our Commentary, we noted that health care institutions and political leaders have an obligation to facilitate health care interventions enabling equitable, efficient, or greater distribution of resources. Educating the public regarding effects of medical care on resource use could be one such intervention. The complex US medical system can lead to a deceptive belief that costly medical services are inexpensive or that "someone else" is paying.¹ A health system in which patients understand limitations on short-term resources could contribute to more equitable and efficient care if this optimizes appropriate use of medical services.

The table also states that patients, health care institutions, and political leaders have obligations to participate in fair deliberation processes enabling equitable, efficient, or greater distribution of resources. Such processes and the policies derived from them could assist . . . [Full Text of this Article]

J. Frank Wharam, MB, BCh, BAO, MPH
jwharam@partners.org
Harvard Medical School
Boston, Massachusetts

Daniel Sulmasy, OFM, MD, PhD
New York Medical College
New York, New York

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