Margaret A.WinkerMD, Deputy EditorIndividualAuthorPhil B.FontanarosaMD, Interim CoeditorIndividualAuthor
In Reply: I would like Dr Houghton
to recognize that the military already lives within a public policy
budget. Congress decides how much to spend on defense and within that
overall budget how much should be spent on the various branches of the
armed forces, procurement retirement the Central Intelligence Agency.
No Congress has ever been willing to give the military everything on
its wish list, let alone everything beneficial.
Now that public policy funds approximately 50% of our health budget,
it is necessary to apply the public policy reasoning to achieve health
care reform. Congress should make an independent assessment of how our
nation can maximize health care with available public funds, how much
of the health budget should be spent on health care, and how to best
organize and deliver that care purchased by public dollars. Congress
should do more than blindly pay bills.
Lamm RD. Marginal Medicine—Reply. JAMA. 1999;281(12):1082-1083. doi:10-1001/pubs.JAMA-ISSN-0098-7484-281-12-jbk0324