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April 28, 1989

The Resource-Based Relative Value Scale

Author Affiliations

University of Massachusetts Medical Center Worcester

University of Massachusetts Medical Center Worcester

JAMA. 1989;261(16):2327. doi:10.1001/jama.1989.03420160051010

To the Editor. —  While the series of articles in the October 28 issue of JAMA points out some of the shortcomings of the current Resource-Based Relative Value Scale study of Hsiao et al,1 none of the articles emphasize that this entire concept is antithetical to the economic principles that operate in a democratic society. Any system that fails to take into account the quality of the product or the experience and skill of the "provider" omits two of the most important driving principles in our American economic system. Would anyone argue that a masterpiece by Van Gogh is worth less than a painting of equal size that is the product of months of work by a high school art teacher? Would any labor union accept a contract that denies seniority and pays beginning workers the same as the most experienced and senior worker? As bizarre as these scenarios