July 3, 1987


Author Affiliations

La Jolla, Calif

La Jolla, Calif

JAMA. 1987;258(1):42. doi:10.1001/jama.1987.03400010046012

To the Editor.—  Although I concur that patient dumping is a serious problem, I do not agree with the recommendations of Drs Ansell and Schiff.1 The responsibility for the medically indigent and uninsured must be shared by everyone, not unilaterally imposed on a selected segment of our economy. It should be noted that we have recently changed the economic ground rules for hospitals; we are now telling these institutions to be fiscally responsible or get out of business. Therefore, it is not reasonable to ask community hospitals to risk financial ruin for the sake of a deficient social policy.Perhaps it is time for our society to embark on a national health care program that directly tends to the needs of the indigent and uninsured. We should accept the failure of our present Medicaid program, which attempts to provide care through indirect subsidies. It has only led to the