Margaret A.WinkerMD, Deputy EditorIndividualAuthorPhil B.FontanarosaMD, Interim CoeditorIndividualAuthor
To the Editor: I found Mr Lamm's
article1 interesting. However, medicine has always dealt
with the individual patient (humanistic medicine). It has never been
utilitarian (thinking about the greatest good for the greatest number).
Utilitarian individuals would not go into medicine, as it makes no
sense to spend $30,000 for a kidney transplant or coronary
bypass on a 40-year-old man, or for any treatment when that same
$30,000 would feed and clothe dozens of starving children and
provide them with vaccinations and basic health care. Is the new
managed care medicine truly utilitarian? Managed care now covers
millions of patients in this country. Yet there is no evidence that
this system is providing more health care at a lower price.
David DS. Marginal Medicine. JAMA. 1999;281(12):1082-1083. doi:10-1001/pubs.JAMA-ISSN-0098-7484-281-12-jbk0324