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Letters |

Managed Care: Success or Failure

Herbert Renz-Polster, MD
JAMA. 2001;286(13):1576-1577. doi:10.1001/jama.286.13.1573.
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To the Editor: The article on the end of managed care by Dr Robinson1 is thought provoking. Medical care in the United States has long had a difficult time reconciling a largely market-driven delivery system with a largely need-driven reality. What Robinson suggests for the US health care system, however, is a new paradigm altogether: a health care system that from its very outset caters to consumers instead of patients. There is a crucial difference between a patient and a consumer—many patients are not consumers because they lack purchasing power, and many consumers are not patients because they lack conditions calling for medical interventions. Consumerism may be the "right thing for US health care," but it poses an ethical dilemma for physicians and other health care workers, who still derive many of their motives, self-respect, and social justification from caring for the suffering patient.

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The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
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