October 8, 1997

Contempo 1997: Economics

Author Affiliations

Gaithersburg, Md

JAMA. 1997;278(14):1149. doi:10.1001/jama.1997.03550140041027

To the Editor.  —The American Medical Association Code of Medical Ethics, like any ethical code, spells out obligations that human beings owe to other human beings, in this case, physicians to patients. When groups of people are dehumanized and thought of as objects rather than as people, ethical standards crumble. It is for this reason that I found the Contempo article on economics by Dr Reinhardt1 so disconcerting.Reinhardt points out that hospital chains, health maintenance organizations, and other large corporate entities that have taken control of the US health care delivery system tend to think of patients as "biological structures that generate net cash flows" or as "insured lives... which insurance companies actively trade among themselves, often with the help of investment bankers on Wall Street." What is even more disturbing is that Reinhardt seems to imply that physicians should embrace this commercial perspective as their own. He even