Medicare's entire premise is wrong

LETTER — Posted March 14, 2005

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Regarding "Fix Medicare's flawed pay system" (Editorial, Feb. 14): Your suggestion that "the defective sustainable growth rate be replaced with a system under which yearly payment changes are based on an assessment of practice cost increases ...," etc., is so much baloney!

The fundamental premise that government can determine the value of any service, let alone a medical service, is fatally flawed, and it should not have ever been allowed to go down this road in the first place. The market is much more efficient at determining the value of any goods or services.

Let's face facts: The United States cannot afford all the care people want until the day they die simply by virtue of their being citizens over 65 years of age.

Sanity would be vouchers for all care with a maximum amount per citizen per year. Period. Let the people decide how much or how little they want up to the proscribed limit and let them either augment this governmental safety net with additional private insurance or proceed to a teaching program for care should they be unable or unwilling to provide for themselves. Let the market determine the value of physicians' services. Insanity is continuing to tweak a system that is unsustainable because the foundational principles are all wrong.

Gregory E. Polito, MD, Whittier, Calif.

Note: This item originally appeared at http://www.ama-assn.org/amednews/2005/03/14/edlt0314.htm.

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