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October 16, 1991

Caring for the Uninsured and Underinsured

Author Affiliations

Wilmington, NC

Wilmington, NC

JAMA. 1991;266(15):2080. doi:10.1001/jama.1991.03470150050024

To the Editor.  —While your editorial1 noted that costs and access—in that order—are the most important problems of medical care in the United States, most of the contributors to your May 15 issue ignored or minimized costs. Maybe that's because it's easier and less hostile to propose spending money—5% more than at present by Rashi Fein,2 $25 billion more by Karen Davis,3 and perhaps $50 billion more by advocates of the Pepper report.4 No doubt, because it's easier to spend money, one of the proposals in your journal will be accepted, thereby making the cost situation even worse.Medical costs are the fundamental problem, terrorizing individuals, corporations, and governments in different ways. After reviewing the medical care policies and programs of five other nations (Great Britain, the Netherlands, Sweden, Germany, and Canada), I believe we should be able to provide comprehensive, quality medical care for virtually