Re "How Medicare pays MDs," Editorial, April 10

It's wrong to blame physicians for Medicare's fiscal woes.

Doing away with fee-for-service as a way to "reward quality and efficiency" is unworkable. The federal government could never figure that out. The small, shriveled carrot it would offer as the "reward" would be an insult to the medical profession.

Medicare's problems, as evidenced by the testimony of physicians fingered in the recent revelations, have to do with outrageous drug, laboratory and facility charges. Medicare shirked its responsibility from its inception in 1965 to control prices except in payments to physicians, who are the bulwark of the program.

We physicians should not be the scapegoats. Do away with fee-for-service and you end the commitment of the dedicated physicians who have tolerated the system this long.

Today, primary-care physicians and general surgeons find it more difficult to survive financially. The problems with our healthcare is the whole system.

Jerome P. Helman, MD

Venice

Re "Medicare pay data shock and anger many doctors," Business, April 10

Jonathan Blum, the principal deputy administrator for Medicare, is quoted as saying, "We want the public to help identify spending that doesn't make sense and that appears to be wasteful and fraudulent."

I don't think so.

Recently I was given a medical brace. Medicare approved a payment of more than five times the price I could obtain online. I was so shocked that I called Medicare to give feedback. The people I spoke with seemed not the least bit interested.

There seems to be no avenue for Medicare recipients to give suggestions on where money is being wasted. So we continue squeezing internists and general practitioners, overpaying certain specialists and not rethinking the system.

There should be an active place for input from Medicare recipients on where money is being wasted. Let Blum tell us where.

Janet Chesne

Santa Monica

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