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Editor's Correspondence
October 26, 2009

The 300-Year-Old Health Care Solution

Author Affiliations

Copyright 2009 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Restrictions Apply to Government Use.2009

Arch Intern Med. 2009;169(19):1806-1818. doi:10.1001/archinternmed.2009.365

The health care reforms described by Diamond et al1 would create “evidence-based” codified medical practice standards. Their proposal and similar “pay-for-performance” programs will lead to “straight-jacket” medicine, in which to receive payment and avoid legal and economic sanctions, the goal will become to ensure that patients receive the correct codified treatment, not necessarily the one best suited. The danger is that patients may receive more inappropriate care, not less, as more who approximate falling within the guideline are included and fewer who fall within guidelines but may have caveats are not excluded—all for assured payment and to avoid penalties.