Margaret A.WinkerMD, Deputy EditorPhil B.FontanarosaMD, Interim Coeditor
To the Editor: Dr Fletcher's thoughtful Editorial1 overlooks the point that publicly held for-profit managed care organizations are under extraordinary pressures not to contribute to the common good. The more they spend on marketing and administration rather than health care and research (their's or other people's), the lower their medical loss ratio and the higher their standing in the financial marketplace.
Yarmolinsky A. Managed Care, Charity Care, and the Common Good. JAMA. 1999;282(17):1619. doi:10.1001/jama.282.17.1619-JLT1103-1-3