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Robert D. Gillette, MD
Family Health Center of St Elizabeth's Hospital Medical Center Youngstown, Ohio

JAMA. 1991;266(8):1080.

	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.

— The recent contribution of Dr Hadorn¹ to the debate on health care financing, insightful as it is in many respects, appears to have two significant weaknesses. First, the author decides to exclude costs as a factor to be considered in setting priorities. This has the advantage of eliminating a slippery, emotion-laden variable from the equation, but, as Dr Eddy² has observed, "To remove costs from the definition of essential care... would separate the concept of essential care from the problem it is designed to solve." This is underscored by the recent release of data indicating that outlays for health care in the United States increased from 11.6% of the gross national product in 1989 to 12.2% in 1990 (Am Med News. May 6, 1991:2). Such increases could have disastrous economic and political consequences.

Hadorn's article also seems problematic in its acceptance of Jonsen's³ . . . [Full Text PDF of this Article]

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