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Roger A. Forsyth, MD
Southern California Permanente Medical Group Pasadena

JAMA. 1994;271(19):1480.

	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 article by Dr Glaser,¹ which recommends a "genuine national health insurance system," dismisses criticisms that such a system leads to "backward technologies, waiting lists, [and] underpaid... physicians," but does not provide any justification for that dismissal. On the other hand, one can readily justify the criticisms. For example, a recent article² stated that France provides dialysis to 88% fewer of its citizens than does the United States, and physician income is only 30% of the US level. Short visits and long waiting lists are a feature of every national health insurance system. These facts should make one pause before recommending a change. What is the virtue of correcting the United States' sin of high expenditures by substituting the sin of inadequate expenditures under a government-mandated global budget?

Similarly, the article summarily dismisses the proposed middle ground of managed competition. The author states that hospital . . . [Full Text PDF of this Article]

Footnotes
Edited by Drummond Rennie, MD, Deputy Editor (West), and Margaret A. Winker, MD, Senior Editor.

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