The cost-containment process requires armies of paid, undereducated people making arm's-length decisions. These regulators of health resources do not see the patient. They go by an ever-changing list of criteria generated by people whose bottom line is a business interest.
The solution is to simplify. In all cases, put some of the patients' resources at risk. For those on welfare, payment of health care should be partially deducted from their welfare check. For those in the private sector, no insurance should pay more than 75% of cost, and this should occur after 25% payment is made by the patient. With personal money at risk, overutilization of the health-care system would be reduced to very acceptable levels.
WILLIAM K. SUMMERS, M.D.