Regarding the April 1 news story “Rules proposed for delivery of care to older Americans”:

As a physician, I have to wonder what parallel universe the Obama administration inhabits, where massive savings ($960 million during the first three years) and bountiful profit-sharing will emerge from the dismal Third World rates it pays through Medicare to primary-care physicians, who have First World expenses in rents, salaries and gas prices. A major portion of the duplication, excessive testing and frequent hospitalizations that the administration is targeting, in fact, is the sole survival mechanism that these Medicare-dependent practices and hospitals rely on to stay afloat these days.

Rather than simply fixing and keeping up the Medicare rates to reflect the costs of operating a doctor’s office and a hospital, so that health-care providers do not have to resort to nefarious games to stay afloat, the Obama administration has chosen to go down the slippery slope to the bottom — who can make the most money by doing the least for patients. The cumbersome bureaucracy that the government is going to have to employ to enforce any of this craziness will not only wipe out any of the ill-gotten gains but will end up decimating the profession of medicine as we now know it.

Jayesh Dayal, Potomac