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letters | a free market for health care?

We need clearer picture of how reformed health care system would look

Jeff Jacoby is on the right track when he discusses the potential role of market forces in controlling the cost of health care, but he doesn’t go far enough (“A free market will help fix health care,” Op-ed, Nov. 28). Jacoby agrees that “markets for medical care can’t be completely free,” but he doesn’t offer enough details on the approach that he advocates.

He needs to deal with the unique issues posed by health insurance, which separates the roles of payer and consumer. He should consider whether there should be real competition among providers in addition to competition in the health insurance market and, if so, how to achieve it.

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Another question is how best to steer patients to efficient, high-quality providers and away from ones who are costly and provide substandard care.

There will probably always be disagreement about the appropriateness of mixing economic considerations with health care concerns, but if those who argue for doing so are to have a fair hearing, they will have to be clearer about what the health care system they visualize would look like.

Richard Wittrup


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