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December 25, 1991

Conflicts in Health Care Spending

Author Affiliations

Baylor College of Medicine Houston, Tex

Baylor College of Medicine Houston, Tex

JAMA. 1991;266(24):3426. doi:10.1001/jama.1991.03470240048030

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To the Editor.  —I was recently struck by the inconsistencies of our health care spending priorities while watching "Good Morning America" on September 11,1991. One of the segments concerned the unfortunate consequences of the practice by an increasing number of private businesses to fire employees who were accused of smoking or of consuming alcoholic beverages in the privacy of their homes or after work hours. There were no allegations of any deficiencies in their work performance, nor were there any accusations of excesses in consumption. The reported purpose of this invasion of the workers' private lives was that the businesses were trying to hold down their health care costs by presumably reducing their insurance premiums.Almost immediately following this segment, the show's host launched into an enthusiastic reporting of another "miracle" of modern medicine—the heart transplantation of a premature infant.The really newsworthy aspect of this case was that the