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December 4, 1987

Philadelphia General Hospital

Author Affiliations

Temple University School of Medicine Philadelphia

Temple University School of Medicine Philadelphia

JAMA. 1987;258(21):3120. doi:10.1001/jama.1987.03400210062019

To the Editor.—  The Letter by Goldberg1 that was recently published as a response to the MEDICAL NEWS & PERSPECTIVES2 feature on the demise of Philadelphia General Hospital requires a response. He is correct in pointing out that the closing of the hospital has not had any adverse effects on the health of Philadelphia's substantial poor population. His comment that "public hospitals are simply not necessary for the care of the poor although they may be politically necessary for the jobs of the bureaucrats" and other statements about public hospitals were fortunately balanced by the Letter from Kirsh,3 published in the same issue.It seems to me that both authors miss the key issue, namely, who is to pay for the care of the poor. Public hospitals care for the poor in some areas; in others, academic health centers do. Academic health centers constitute only 6% of