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Robert D. Gillette, MD
St Elizabeth Family Health Center Youngstown, Ohio

JAMA. 1990;264(11):1409-1410.

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

To the Editor.—

Ginzberg¹ addresses some major concerns relating to health care financing, but unfortunately he blurs the issues rather than clarifies them. He defines "high-tech medicine" as "the sum of all the advances in medical knowledge and technique... during the past several decades." He makes no distinction between universally applicable, obviously cost-effective accomplishments such as rubella vaccine and other inventions (eg, mechanical respiration) that are lifesaving when correctly applied but not justifiable in relation to their cost if used inappropriately, as, for example, to prolong oxygenation of persons who have no chance of regaining meaningful life. Significant recent health care advances of a nontechnological nature, primarily in the area of relationships between illness and human behavior,^2,3 appear to have been ignored in the author's analysis.

The essay posits and then attempts to refute some global assertions that overstate what responsible critics of our health care system are . . . [Full Text PDF of this Article]

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