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Sept 4, 1967

Organizing and Delivering Health Care—Part 2

JAMA. 1967;201(10):767. doi:10.1001/jama.1967.03130100065018

Last month I expressed my conviction that health care can be provided, at the highest level of quality and at a reasonable price, to an ever-increasing population in a context of competitive enterprise. I indicated also that the medical profession and its many allied associates must be sure they understand the basic features of such a system. Although professional and economic components are involved in the delivery of health care, this discussion will concern itself primarily with the economic aspects.

In such an exchange, the freedom of choice of a physician by a patient is of primary importance. When a patient selects a physician who agrees to render professional care, a contractual arrangement is created. In a sense, the patient is the employer and the physician the employee. Direct responsibility of each to the other continues until the relationship is ended by mutual consent or until the health problem has