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Invited Commentary
June 2014

Improving Value Is Improving Health Care, Not Rationing

Author Affiliations
  • 1Press Ganey, Wakefield, Massachusetts
JAMA Intern Med. 2014;174(6):847-848. doi:10.1001/jamainternmed.2014.439

Hegel’s Triad—thesis, antithesis, synthesis—suggests that when good people disagree, the issue is not which is right, but how to integrate the 2 perspectives. In this issue of JAMA Internal Medicine, Goitein1 raises concerns about the potential dangers of providing physicians with financial incentives to become more efficient. Although I respect her concerns, I also respect concerns articulated by Berwick and Hackbarth2 and others that we are at a point of crisis that demands a dramatic response from physicians and other clinicians. Simply put, health care is consuming too much of society’s resources and failing all too often to meet patients’ needs.

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