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The Underinsured and the Uninsured

Arch Surg. 1991;126(5):551. doi:10.1001/archsurg.1991.01410290023002.
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The so-called crisis in health care speaks to a situation whose solution is overwhelming the most ambitious among us. As in other "larger than life" crises, it is easy to separate ourselves from the problem, leaving its solution to apparently mightier powers. Often we stand back from the issues; rarely do we identify ourselves as part of the problem. We are numbed into complacency because our life and practice are not directly touched; or, if they are, it is in a way by which we can shamelessly dismiss the problem as society's, or the public hospital's, or somebody else's (whoever that is!). In some practices, the wallet biopsy is the first procedure performed, and "greenopenia" is the diagnosis justifying transfer to the public facility, or the "teaching service."

Most of us became physicians because we wanted to care for other people. Changes in the practice of medicine have subverted the


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