Health, market forces, and debate in medical care: room for controversy.

In this issue of Medical Care, we present a bundle of 3 manuscripts organized as “Point,” “Counterpoint,” and “Reply.” We initially received the article, Vulnerability of Health to Market Forces, by Brezis and Wiist, as an unsolicited manuscript submitted for peer review; it did not clearly fit the mold of original data-driven research usually published in our journal. However, we believed the issue to be both so important and so controversial that it might justify starting a debate in the pages of Medical Care. Thus, we invited a Counterpoint and gave the authors of the initiating manuscript an opportunity to respond to the Counterpoint. Indeed, the debate does not end with these 3 articles. To continue the discussion, we have initiated a blog monitored by the Editors of Medical Care (http://journals.lww.com/lww-medicalcare/blog/PointCounterpoint/pages/ default.aspx). We hope to hear from our readers, and to continue the debate with a tone of scholarship and civility. Compared with the traditional editorial process, the Point-Counterpoint approach conveys significant advantages for the presentation of controversial topics. For example, editorials typically place the original work in context, but may not present opposing viewpoints. Letters to the editor generally focus on specific, and often idiosyncratic, concerns of the author; and rely on the chances of having read the original article. The Point-Counterpoint approach ensures a more global examination of the controversy and more carefully defines the relevant questions. Also, it allows the selection of a respondent with appropriate expertise. We are herewith soliciting future submissions on topics that are controversial, of interest to readers of Medical Care, and amenable to scholarly and civil discourse. After submission of the original opinion manuscript, the Point, the editors will make arrangements for the Counterpoint piece, to which the original author(s) may also respond. The complete set of manuscripts will be subject to peer review. The suggested format corresponds to that of full-length manuscripts for both the Point and the Counterpoint, with the final reply having the format of a brief report. We look forward to lively contributions to the national discourse on our changing healthcare environment.