<h3>To the Editor.—</h3> In her recent<i>JAMA</i>article, Dr Angell<sup>1</sup>offers some thoughts on how to address the problem of the medical community spending too much money on health care. Among the several remedies suggested were the following. First, physicians should eliminate unnecessary medical care. I agree we should try, but given the amount of success that the Department of Defense has had in eliminating waste in the military I am not optimistic that physicians can do much better in medicine. Second, peer-review mechanisms would decide which new technologies are beneficial before funding is provided on a grand scale. Who will decide and how was not addressed. Meaningful peer review has not been one of medicine's great accomplishments in the recent past. Third, "fee schedules should be revised so that they neither encourage nor discourage the use of tests and procedures." I predict that this will be like tax