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November 23/30, 2005

“Manufacturing vs Repair” in Health Care

JAMA. 2005;294(20):2580. doi:10.1001/jama.294.20.2580

To the Editor: In his Commentary on efficiency in the health care industries, Dr Grove1 provides an outside view, offering a business analogy that fails to consider that medical care is a repair service, not a manufacturing operation. Manufacturers prosper by carefully choosing their materials, procedures, and products. Medical care is stuck with faulty carbon-based people who walk in the door to receive US Food and Drug Administration–approved treatments. With his analogy, the questions to consider are how profitable Intel could have been if its core business was repairing failed Motorola chips, and how much more profitable a medical facility could become if it eliminated patients who, before they became ill, were drug abusers, alcoholics, smokers, or obese.

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