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November 12, 1997

Moral Medicine and Universal Health Care

Author Affiliations

University of Washington Seattle

JAMA. 1997;278(18):1494. doi:10.1001/jama.1997.03550180044033

To the Editor.  —The Editorial1 "Crisis, Ethics, and the American Medical Association: 1947 and 1997" was important and timely. However, I do not believe that "[t]he main challenge facing medicine today is to ensure that free-market medicine remains moral medicine." On the contrary, I believe that the main challenge of American medicine is to use its influence to promote the development of a universal health care system in this country. "Moral medicine" is more easily assured in a universal system. That the medical establishment has missed every window of opportunity over the past half century to foster its development is probably one reason for the crisis in free-market medicine. Conditions in the United States stand in stark contrast to those in Taiwan, which has a universal health insurance system, described in the same issue.2 Taiwan was a third-world country 3 decades ago and now has a successful industrial