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June 20, 2007
Commons
JAMA 297, 22 p 2518 is a commentary entitled, Managing Medical Resources: Return to the Commons? I must admit, this taxes my powers of understanding. They refer back to Hiatt's article adapting Hardin's "Tragedy of the commons." Somehow they seem to twist it backwards. The commons (which is destroyed should every farmer graze his livestock freely) is the health care system under fee-for-service. They examine various proposals as to why the commons is destoyed. They conclude, "Physician engagement in a medical commons, ideally with communities of consumers, is arguably the only approach that will ensure proper allocation of health care resources."
Why speak of a commons? What have I missed? I thought the point was that each patient acting in his own best interest, advised by a doctor with that patient in mind, was the goal of medicine.
| By Robert Maddox | 12:31 AM