The subject of medical reform and HMO's is one area where people of 'good will' can have valid differences. But those views may still not provide the solution that seems so illusive to develop. Profit is good in business. But is medicine really a business and should the normal rules of the market apply in the same manner? Current legislation avoids the central issues. Let us agree that the goal is quality of service, proven methods of diagnosis and treatment, value in costs, and widespread availability. A single payer system can never satisfy these requirements. A lesson from another era, seems to have been lost, and may well be the cure we are looking for. A physician has traditionally been in practice as an independent venture. Pay for service, supplemented with individual insurance was the standard. HMO's developed out of a need to curb spiraling costs and were formed as profit centers. Most businessmen dread administrative duties.
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