Letters Section Editor: Stephen J. Lurie,
MD, PhD, Senior Editor.
In Reply: Dr Howe argues we should have adjusted
for pharmaceutical use because beneficiaries who use multiple medications
would be attracted to MMC plans for their prescription drug coverage and then
face rising premiums.
As we stated in our article, our survey is designed to measure consumer
experiences with specific aspects of care, irrespective of benefit design.
The fact that some Medicare beneficiaries may have had premiums that were
higher than expected should not affect their reports about specific care experiences
that are unrelated to prescription drug benefits. With the possible exception
of the overall rating of the plan (or Medicare), the specific ratings and
composites that we used (Table 1 in our article) are unrelated to drug coverage
Landon BE, Zaslavsky AM, Cleary PD. Fee-for-Service vs Managed Care Medicine—Reply. JAMA. 2004;292(2):170. doi:10.1001/jama.292.2.170-b