To the Editor.
—In his timely and provocative article1 in the December 1988 issue of the Archives, Frenkel discusses the likelihood of a continuing reduction in Medicare fees for ophthalmic surgery and the theoretical increase in fees for such cognitive services as comprehensive eye examinations.It is highly improbable that Medicare has any intention of significantly raising any fees. The sole purpose of its recent actions has been cost containment, regardless of the effect on the patient, the provider, the hospital, or the future of health care. Medicare has not been especially forthright about this, describing routine services as "not reasonable and necessary" simply because it did not wish to pay for them. The Health Care Financing Administration did not arrange this elaborate study to redistribute payment among providers while total outlay remained about the same. Payment for procedures may be reduced, but fees for consultation are unlikely to
Copeland AM. Resource-Based Relative Value Scale and Medicare. Arch Ophthalmol. 1989;107(4):486. doi:10.1001/archopht.1989.01070010500005
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