To the Editor: In their Commentary, Drs Berenson and Cassel1 argued against the use of high-deductible health plans and tax-advantaged health savings accounts. They contended that such policies “plac[e] increased reliance on commercial ethics while eroding professional ethics as the guiding force for patient-physician interactions.” A physician's fiduciary duty to the patient is of paramount importance, but increased competition for health care services does not inevitably dismantle professionalism. To the contrary, a perfected health care marketplace would reduce unethical behavior.
Herzlinger RE, Falit BP. Consumer-Driven Health Care. JAMA. 2009;301(20):2093–2094. doi:10.1001/jama.2009.699