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May 18, 2005

Holes in the Swiss Health Care System—Reply

Author Affiliations

Letters Section Editor: Robert M. Golub, MD, Senior Editor.

JAMA. 2005;293(19):2337-2341. doi:10.1001/jama.293.19.2339-c

In Reply: Suppose Americans spent vastly more than residents of other countries on personal computers (PCs) and networking. Few would argue that the US government should limit PC spending. Personal computers result in increased productivity, people buy them because they want them, and unique US characteristics, such as low density of population, require more networking. Similarly, it does not seem appropriate to use health care’s share of US gross domestic product and average longevity as justifications for centralized government control, as suggested by Dr Vogt. Health care consumption increases with affluence1 and, like PCs, health care expenditure benefits the rest of the economy.2 Furthermore, average longevity in relatively homogeneous countries whose citizens have favorable genetic, age-related profiles is simply not relevant to the US melting pot. For example, in Los Angeles, Calif, the prevalence of diabetes is 11.8% among Latinos and 9.9% among African Americans compared with 5.6% among the white population.3