Dr. Stephen Kemble’s excellent analysis describes how administrative costs of “value-based” payment for physician’s services are too high to effectively lower the price of health care for patients (“Administrative costs of ‘value-based’ health care too high,” Star-Advertiser, Island Voices, Jan. 24).

Targeting physician’s fees and services, which account for 10 percent or less of the total health-care cost, by the Affordable Care Act, has failed to reduce costs for the patients. Indeed, the unproven theory that the increase in U.S. health-care costs was driven by excessive fee-for-service led to the adoption of capitated payments for primary doctors.

Medicare could reduce total health-care costs by addressing escalating and excessive pharmaceutical costs, which make up at least 30 percent of the total health-care cost.

A good start in cost reduction would be for Congress to rescind its prohibition for Medicare to have pharmaceutical companies bid for the drug pricing.

Malcolm Ing, M.D.

Nuuanu

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