Stephen J.LurieMD, PhD, Senior EditorIndividualAuthor
In Reply: My intent was not to repackage old
ideas about the uninsured but to draw attention to the increasingly systemitized
system of barriers they face,1 not to blame
private physicians but to impugn a nonsystem that financially punishes those
who care for the poor, not to engender guilt but to fuel collective purpose.
Although it was the focus of my essay, the problem of uninsurance has
vanished from Dr Knoll's letter. He replaces it with the doctrine of individual
responsibility: the central problem with the US health system is "the patients
themselves." The logic, apparently, is this: if the uninsured practiced better
health habits they would not need so much medical care, thus making irrelevant
their lack of insurance. Never mind that much illness is not preventable.
Ferrer RL. Poverty and Responsibility for Health Care—Reply. JAMA. 2002;287(8):988-989. doi:10.1001/jama.287.8.983