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October 16, 1991

Caring for the Uninsured and Underinsured

Author Affiliations

Chicago, Ill

Chicago, Ill

JAMA. 1991;266(15):2078-2079. doi:10.1001/jama.1991.03470150050019

To the Editor.  —Physicians for a National Health Program1 ascribe the high cost of medical care to administrative waste. Too many payers complicate our payment method. A monopsonistic system with only one payer would drastically reduce administrative expenses incurred. The funds saved would go a long way toward paying for the 35 million persons listed as indigent, nonreceivers of medical care. Perhaps the monopsonistic system will be introduced state by state.The Canadian system has been touted as being the model for a new approach to health care provision. It may be that such a system would not be viable in the United States because of society's demands for immediate treatment. Medicare is adequate for care of the elderly. Could this diagnosis related group system not be extended to cover those 21 to 65 years of age under a national comprehensive health care system? If so, how are we