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September 4, 1991

Let's Provide Primary Care to All Uninsured Americans—Now

Author Affiliations

Gage County Medical Clinic, PC Beatrice, Neb

Gage County Medical Clinic, PC Beatrice, Neb

JAMA. 1991;266(9):1215. doi:10.1001/jama.1991.03470090049017

To the Editor.  —Dr Moore1 has joined the long list of public officials who have figured out the obvious solution to our nation's health care woes. Like many who have gone before him, his views arise out of what appear to be major misconceptions about primary care medicine.The first and biggest problem is the conspicuous absence of Moore's definition of basic or front-line care. Everyone seems to be in favor of guaranteed basic health care for all Americans, but I have yet to read anybody's conception of this that does not imply rationing. If rationing is where we are headed, let's call it that. Rationing is not a medical issue, it is an economic and political problem, and it needs to be dealt with in those arenas.The second major problem with Moore's assumptions is his statement regarding the need to eliminate fees-for-service and provide prepaid packaged care.