Letters to the editor express opinions on issues of the day. When in the discussion of the Affordable Care Act, Keith Miller suddenly evokes the specter of Reverend Jeremiah Wright; he has strayed far from rational discussion.
The cost of medical care has little to do with the means by which the country supplies it. It has everything to do with how we practice medicine. The incentives are wrong. They encourage more services, rather than better services.
Take the total budget for physician services, multiply it by the number of practitioners and you get the cost of the professional component of care. Pay the exact dollar amount to physicians on salary and stand back as the overall cost of medical care declines dramatically as physicians no longer have to do more to earn more. Moreover, that average salary will be high enough to maintain and grow the profession unless potential physicians decide to become investment bankers instead.
Personally, I prefer a single payer system, i.e. Medicare for all. That system gives the best bang for the buck and the lowest overhead. To reiterate, any system, private or public that doesn’t change how we practice medicine is doomed to fail.
Lawrence Gold, M.D.