Abstract
Encapsulated in this exchange is a conflict of perspectives that has profound implications for the future of American medicine. This conflict has received very little attention in the media (indeed, the article quoted above may be the first and only treatment of the topic in a major newspaper) or in health care reform legislation, but observers should not be deceived. Underlying the views of Dr. James on the one hand and Mr. Robinson on the other are fundamentally different theories concerning human motivation, organizational behavior, and the role of regulation in society generally, and the medical sector in particular. Adherents to these theories are currently contending for the hearts and minds of public policymakers and private sector managers. The outcome of this debate could significantly influence how quality of care is promoted in the future and the role of markets in th health care system.
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