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September 26, 1977

Rising Cost of Medical Care

JAMA. 1977;238(13):1361. doi:10.1001/jama.1977.03280140039004

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To the Editor. —  In his commentary "A Prescription for the Rising Cost of Medical Care" (237:2383, 1977), Vernon Mark, MD, suggests the abandonment of Medicaid in favor of a municipal, county, and state hospital system, which he feels could provide the services needed by the medically indigent more cheaply, without sacrifice in quality of services, and with less fraud. He implied that the problem of the old government hospital system related to physical facilities, not to inadequate medical care. I do not agree.Seattle-King County has had a better county hospital than most in the country. Hospital care provided there in the past and currently has technically been good, often excellent. Today it still sees many Medicaid patients as part of the medical care mainstream (as it should be). The patient has freedom of choice to the extent that the private sector is willing to participate in Medicaid.During the