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He said market-based medicine assures unaffordability, "variable quality," and inequity for millions. Only bottom line priorities matter. Patient needs are sorely neglected.
"Our present medical care system lacks the structure and incentives to provide proper care....A real solution to our crisis will not be found until the public, the medical profession, and the government reject the prevailing delusion that health care is best left to market forces.""Once it is acknowledged that the market is inherently unable to deliver the kind of health care system we need, we can begin to develop the 'nonmarket' arrangements for the system we want."
On March 19, The New York Times published Relman's letter headlined, "The Health Law Mandate," saying:
The Times' March 9 article titled, "White House Set to Shape Debate Over Health Law" omits a key argument against PPACA's "mandated purchase of private insurance, the key issue before the Supreme Court."
He said 50 doctors and two nonprofit organizations filed an amicus brief. It argued that "Congress could avoid a mandate by legislating a national single-payer system that provides nearly universal insurance coverage."
Though flawed, comparable systems exist - Medicare and veterans' health benefits. "(N)o legal barriers prevent doing more."
"Since a mandate isn't necessary for Congress to exercise its legitimate role in regulating health insurance, there is no justification under the Constitution's 'necessary and proper' clause for such a legislative requirement."
How this argument influences the Court "remains to be seen. But the brief is another reminder that the single-payer idea, although currently off the table in Washington, should not be counted out."
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