Health insurance coverage is low among the self employed in the United States, relative to the coverage among wage earners. This is causing substantial public policy concern. Using data from the medical expenditure panel survey conducted in 1996, Perry and Harvey suggest that the link between insurance and utilization of healthcare services is not as strong as assumed in the policy debate. For a number of medical care services, the self employed have the same rates of utilization as wage earners, despite the fact that they are substantially less likely to be insured. In addition, when the self employed are less likely than wage earners to utilize a particular medical service, the differences generally do not seem very large. The self employed thus appear to be able to finance access to healthcare from sources other than insurance. Further, analysis of out of pocket expenditures on healthcare suggests that doing so does not lead to substantial reductions in their ability to consume other goods and services. Finally, there is no evidence that the children of the self employed have less access to healthcare than the children of wage earners. The public policy concerns that the relative lack of health insurance among the self employed substantially reduces utilization of healthcare services or creates economic hardship appear to be misplaced. In his comments he reviews various extensions and amendments to the empirical specification of the Perry Rosen study in order to get a feeling of whether the results are robust with respect to the underlying assumptions. He believes that analyzing cross section data with reduced form models may not be the most efficient way to extract as much useful information as possible from the data. Risk management is the identification, control and prevention of risks that can have an adverse effect on patient care. The goals of healthcare risk management are always to improve the quality of patient care and reduce the frequency and severity of malpractice claims. National data indicates that the most common dental malpractice claims include the diagnosis and treatment of infection, delay in diagnosis and treatment of periodontal disease, procedures performed on the incorrect tooth, paresthesia secondary to third molar extraction, and the operative management of temporal mandibular disease. Any patient can become a malpractice plaintiff with sufficient motivation. A patient can sue for any reason. Some of the most common reasons include dissatisfaction