From the results of a survey, McCormick et al1 conclude that a single-payer national health insurance is more acceptable to physicians than a managed care or fee-for-service system. Part of this conclusion was based on the willingness of physicians to accept a 10% fee reduction or a 10% salary reduction in exchange for the postulated benefits of the new payment method including, most significantly, paper work reduction. Of the physicians surveyed, 67% stated that they would accept a fee reduction and 57% would accept a salary reduction. Why two thirds of physicians accepted a system that is likely to cost them twice as much was not explained.