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Ole J. Thienhaus, MD
University of Cincinnati Medical Center Cincinnati, Ohio

JAMA. 1994;271(19):1482.

	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 Glaser¹ on health system reform was remarkably lucid and thoughtful. I would like to add two comments. First, I believe that Glaser's concept is quite compatible with a single-payer model. Universal social insurance does not need to be the treasury (as it is in Canada). On the other hand, I see no advantage in a multiplicity of social insurances if we agree that classical market dynamics are not relevant to the problem. I am aware that in Germany, for instance, there are multiple sickness funds for historical reasons. Working in that system for 2 years as a primary care physician was fine, but having to use different prescription forms depending on the kind of sickness fund responsible for the patient was time-consuming and inconvenient. That inconvenience is not matched by any noticeable advantage to patient, provider, or any other component of the . . . [Full Text PDF of this Article]

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