Reversing the escalation of health care costs is going to need more than legislation, yet it can be done without imposing rationing, as critics of reform fear.

The fact is, if our primary legislative goals are to repeal and replace the health spending bill; to end the bailouts; cut spending; and shrink the size and scope of government, the only way to do all these things it is to put someone in the White House who won't veto any of these things.

Physicians today, as human beings, are not exempt from the perverse economic pressures created by fee-for-service regimes to see more patients for shorter appointments and order more tests and procedures. If the incentives were changed to pay to foster better health outcomes, I am convinced physician behavior would change over time.

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