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July 6, 2005

Single-Payer Health Systems and Statistics—Reply

Author Affiliations

Letters Section Editor: Robert M. Golub, MD, Senior Editor.

JAMA. 2005;294(1):43-44. doi:10.1001/jama.294.1.44

In Reply: Goodman et al1 explain that outcomes such as life expectancy and infant mortality are a function of many factors besides medical care. Important variables include diet, social status, social stability, wealth, and risk-taking behavior—as well as genetic endowment. Additionally, they argue that the health of US residents is not poorer than that of people who live under single-payer health systems. Their argument is buttressed by extensive references to official statistics and the medical literature, which cannot be cited in a brief book review or letter.

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