This Article  • Full text  • PDF  • Send to a friend  • Save in My Folder  • Save to citation manager  • Permissions  Citing Articles  • Contact me when this article is cited  Related Content  • Related article  • Related letter  • Similar articles in JAMA  Topic Collections  • Medical Practice  • Health Policy  • Medical Ethics  • Medical Practice, Other  • Alert me on articles by topic  Social Bookmarking   What's this?

	Since this article does not have an abstract, we have provided the first 150 words of the full text and any section headings.

To the Editor: In their Commentary, Drs Berenson and Cassel¹ argued against the use of high-deductible health plans and tax-advantaged health savings accounts. They contended that such policies "plac[e] increased reliance on commercial ethics while eroding professional ethics as the guiding force for patient-physician interactions." A physician's fiduciary duty to the patient is of paramount importance, but increased competition for health care services does not inevitably dismantle professionalism. To the contrary, a perfected health care marketplace would reduce unethical behavior.

We reject the authors' argument that a health care system driven by competition leads to unverifiable assertions about cost and quality and to the delivery of care "grounded in the philosophy of caveat emptor." We believe that inappropriate self-referral and the overuse of generously reimbursed procedures are primarily caused by informational asymmetries and a poorly designed compensation system, not commercialism per se. Improvement in patients' incentive and capacity to shop . . . [Full Text of this Article]

Regina E. Herzlinger, DBA
rherzlinger@hbs.edu
Harvard Business School
Boston, Massachusetts

Benjamin P. Falit, JD
Yale University School of Medicine
New Haven, Connecticut

CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    Twitter     What's this?

RELATED ARTICLE

Consumer-Driven Health Care May Not Be What Patients Need—Caveat Emptor
Robert A. Berenson and Christine K. Cassel
JAMA. 2009;301(3):321-323.
EXTRACT | FULL TEXT  

RELATED LETTER

Consumer-Driven Health Care—Reply
Robert A. Berenson and Christine K. Cassel
JAMA. 2009;301(20):2094.
EXTRACT | FULL TEXT