To the Editor.
—I cannot disagree with the focused content of the article by Dr Drake.1 However, I believe the title is somewhat misleading in that it implies that the phenomenon of managed care can be interpreted in a fashion analogous to other markets. Although market forces are at work, this is a distorted solution to a distorted market.The "growing frustration of employers" with health care inflation is not meaningful in and of itself. For example, employers are not frustrated with the incredible increasing expense of computerization. Computerization is an expense they feel has value. However, they are frustrated that they have no control over the expense of health care, and they could not trade off this expense for another because of the link that had been established between health care coverage and employment. Through government intervention, health care premiums became deductible, and wage freezes made health care
Farrell JP. Purchase of Managed Care: Informed Consumers or a Distorted Market? JAMA. 1997;277(19):1517–1518. doi:10.1001/jama.1997.03540430029023
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