The Rand Experiment and Economical Health Care

To the Editor: My enjoyment of the Rand study of a health-maintenance organization by Manning and colleagues¹ was somewhat dampened when I read the accompanying editorial.² In several instances statements made by Enthoven seem to be at variance with what the authors report in their article. First of all, Enthoven repeatedly labels the Rand study a randomized clinical trial. It is not described as such in the Abstract, introduction, or Methods section of the article, nor do the authors label it as such in the title. Secondly, Enthoven contends that the Rand study “has provided solid evidence that consumers respond.