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David, I couldn't agree with you more: good medicine is both less expensive and more effective.

But incentives for best practice have to be real--and that doesn't necessarily mean higher income for physicians.

We need a far more rational allocation of resources (more to primary care and prevention, for example) and we need to use savings to invest in community health resources--not more profits to insurance companies, which cost us money but add no value to our health care system!

I totally agree that the Patient Protection Act is only the first timid step in this direction. It will take a strong and persistent alliance of progressive practitioners and community organizations (such as unions) to move us rapidly and effectively toward a health care system that gets both our costs and our health care outcomes more in line with the rest of the developed world.

David Newby, President
Wisconsin State AFL-CIO

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