Margaret A.WinkerMD, Senior EditorIndividualAuthorPhil B.FontanarosaMD, Senior EditorIndividualAuthor
In Reply.—Only Mr Epstein answers my
pointed question forthrightly; Dr Lindsay and Dr Lally beg the question with
Epstein considers it perverse to give more health care to poor children
than to rich children whose parents can help them avoid illness or injury.
To call giving disenfranchised children the health care that their parents
cannot or neglect to give them a "deviation from what is considered right
and good" (the meaning of "perverse") reflects his distinct social ethic and de gustibus non estdisputandum.
I wonder how many other Americans share that ethic? As to his query as to
why redistributing wealth through health care is preferable to a full-scale
but destructive redistribution of wealth, one answer is this: targeting subsidies
narrowly on health care to avoid acute human suffering or stave off early
death requires much less redistribution.
Reinhardt UE. Articulating a Social Ethic for Health Care—Reply. JAMA. 1998;279(10):745-746. doi:10-1001/pubs.JAMA-ISSN-0098-7484-279-10-jac80000