Series on the Quality of Health Care

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Abstract
In “Quality of Care — What Is It?” (Sept. 19 issue),1 the first article in the series on the quality of health care, Blumenthal asks the wrong question. He should have asked, “Who should be the judge?” Blumenthal discusses how the experts and central planners try to determine what is good health care. This top-down method will not work. Choices about quality in medicine are no different from choices about quality in other areas of life, such as purchasing an automobile. Would we turn over to auto makers the task of deciding which car is best for us? Of course not. Yet this is what we have done in medicine. This simplistic notion puts managed-care companies in charge of choosing quality.