To the Editor

----- Original Message -----
To: letters@pressofac.com
Sent: Wednesday, May 13, 2009 8:01 AM
Subject: Health Care Costs

The letter writer (Voice of the People, 5/13) is right when she notes that malpractice suits constitute only a relatively small percentage of total health care costs. She is wrong, however, when she posits, instead, that excessive "paperwork...and huge salaries...of insurance executives" are "the reason for the outrageous cost of health care." We do need to streamline the administrative aspects of our medical system. And we do need tort reform. But physicians, themselves, directly or indirectly, generate the vast majority of health care costs: only physicians admit patients to hospitals and determine their lengths of stay, only physicians perform surgical procedures, only physicians order diagnostic tests and prescription drugs. Want to reduce "outrageous" health care costs? To do so, one must recognize that costs are a function of both price (fees) and volume (utilization); both factors must be addressed simultaneously. First, develop fair and consistent provider fee schedules that control fee escalation and reward effective, efficient professional practices. Second, implement mandatory educational provider Quality Assurance Programs aimed at eliminating unnecessary, inappropriate (and often dangerous) medical services. As we achieve optimal quality, optimal utilization (and cost) must follow, automatically and inevitably.