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July 2, 1997

Professionalism vs Commercialism in Managed Care: The Need for a National Council on Medical Care

Author Affiliations

University of Maryland Baltimore County

JAMA. 1997;278(1):21. doi:10.1001/jama.1997.03550010035023

To the Editor.  —Drs McArthur and Moore1 present an elegant (but depressing) description of the hazards in commercial medicine. But I question the effectiveness of the proposed new national agency to establish standards for and surveillance of medical commerce and prepaid plans.The eminent political scientist Harold Lasswell defined politics as "who gets what, when, where and how." The issues that the proposed national agency would have to address are essentially political issues, and in either of the proposed models, it would have to deal with these issues. Rather than cobble together an assemblage of the great and the good to protect the rights of patients and caregivers, it would seem wiser in the end to rely on government itself, which, according to Thomas Jefferson, is instituted to secure these rights, among others.It is a natural instinct to prefer self-regulation to the heavy hand of government, but events have already demonstrated