To the Editor.
—The article by Dr Shoemaker and colleagues1 is appalling. The statements by the authors that "medicine" or "medical reform" should engage in "a reform of both science and society" has no basis except in social engineering concepts not based on fact.To quote the history of a 19-year-old black man who came to the King/Drew Medical Center, Los Angeles, Calif, in September 1990 with the tremendous hospital cost of over $500 000 does not make the case assumed by Shoemaker and his colleagues. To say that "appropriate education and job opportunity could have provided alternatives to the drug incident that led to this... lethal injury" and that "[t]his case, though unusual, represents the extreme costs that at times beset inner-city hospitals where social events dominate and violence becomes the response to social injustice" is not facing the problem. "Social injustice" is a large basket to describe