The commentary, "Medical Refugees in America," by Dr Alpert1 was a description of "what is" but lacks an insight on "what ought to be." It lacks the causes of the defects in the present health care delivery system. The present system has deficiencies throughout all levels of its organization. The roots of the problem lead to the psychodynamics of the individual who fears death and wishes to remain immortal. Successful politicians are practicing psychologists. They recognize that voters want warm and fuzzy health care during any and all adversities. Any rational thinking will conclude that there is a limit to politicians' resources. Citizens must give an upper limit to the amount of money that they are willing to devote to health care: what percentage of the gross national product and what percentage of their personal income? Without an answer to this question, no health care plan will succeed. The resources are finite and the demands are infinite.
Tucker WH. Social Security—Good Concept, Bad Execution. Arch Intern Med. 2000;160(17):2680-2681. doi: