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February 2, 2000

Quality of Health Care and the HMO Marketplace

Author Affiliations

Phil B.FontanarosaMD, Deputy EditorIndividualAuthorStephen J.LurieMD, PhD, Fishbein FellowIndividualAuthor

JAMA. 2000;283(5):602-605. doi:10.1001/jama.283.5.601

To the Editor: The article by Dr Himmelstein and colleagues1 is a clear example of drawing inappropriate conclusions to advance a thinly veiled agenda: for-profit HMOs are bad and national health insurance is needed. The authors have extrapolated from a set of problematic proxy data (HEDIS), voluntarily reported by a nonrandom sample of HMOs, to draw the illogical conclusion that quality of care in investor-owned HMOs is inferior to that of not-for-profit HMOs. Lacing the article with statistical jargon may obfuscate but cannot hide the authors' apparent disregard for the scientific method.

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