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Better Care At Less Cost Without Miracles, Edmund K. Faltermayer

MCV/Q, Medical College of Virginia Quarterly

Our present system of medical care is not a system at all. The majority of physicians, operating alone as private entrepreneurs, constitute an army of pushcart vendors in an age of supermarkets. Most patients pay by the cumbersome "fee-for-service" or piecework method, which involves separate billing for visits to doctors, shots, x-rays, laboratory tests, surgery, anesthesia, hospital room and board, etc., etc. The American hospital system, as Herman M. and Anne R. Somers of Princeton University said in their book, Medicare and the Hospitals, "is largely a figure of speech," the result of a haphazard growth of isolated, uncoordinated institutions.