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—The May 15, 1991, issue of JAMA, upon which my comments were based, was devoted to the subject of access to health care. Neither that issue nor my article sought to address all elements of health care reform. I sought to point out that access alone is an insufficient goal of reform efforts. It is my contention that the prevention of disease and disability and the promotion of good health must be at the cornerstone of an effective American health care system.That I did not mention malpractice insurance reform in my article does not, contrary to Dr Romano's letter, indicate a lack of interest in or unfamiliarity with this issue. The costs of malpractice insurance and the less readily documented costs of defensive medicine practiced by worried physicians certainly contribute to our health care costs. My views on this and other issues facing our health care system
Harkin ST. Another Pound of Cure-Reply. JAMA. 1992;267(3):365-366. doi:10.1001/jama.1992.03480030043029