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April 5, 1995

Health System Reform: Still Twitching

Author Affiliations

Maitland, Fla

JAMA. 1995;273(13):997. doi:10.1001/jama.1995.03520370037023

To the Editor.  —The article by Dr Schiff and colleagues1 is a utopian paean intended to convince us that a system of health care financing that has failed or is failing everywhere it has been tried can succeed in the United States, perhaps because we are better people than those who have tried it before. The authors suggest that Canada shows us the proper path, even though Canada suffers from medical cost inflation, shortage, long queuing, and rationing. This hardly seems a prescription for improving a system where no one is denied essential care and almost all services are available immediately, year-round.Schiff et al state, "Patient voices must be amplified so that their needs can be better addressed." Under the current nonsystem, each patient is a single voice among thousands covered by a single insurer, with only a small chance of being heard when complaining. It is ludicrous

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