Regarding “Fee-for-service: A rash that just won't go away:”

There is nothing wrong with the basic ethical concept of reasonable payment for appropriate service provision. Ending the fee-for-service system will also force all physicians into an employed status that will force them to put the welfare of the system ahead of the welfare of their patients or face economic consequences.

This will destroy the doctor-patient relationship and result in rationed care by creating long waiting lines for needed care. For all the railing against the U.S. system of medicine, there are two areas where the U.S. system is unquestionably No. 1. Responsiveness to the needs of the individual patient and shortest waiting times to needed care, and the fee-for-service system is largely responsible for this.

Dr. Thomas M. Flake Jr.
General surgeon
Southfield, Mich.