Cost of Medical Care

To the Editor.—  The editorial on superselective angiography (240:1271, 1978) cannot be allowed to go without comment. There is a clear implication in the editorial that any concern about the cost of new procedures means that advances will not be used and that research should therefore be stopped.There is much concern about the cost to the community of such items as intensive care units, respiratory therapy, computerized tomographic scanning, coronary bypass surgery, fetal monitoring, and superselective angiography. Those concerned about costs recognize that all of these, appropriately used for the proper indications, are extremely valuable. But Dr Sugar need only follow the literature to be aware that there are many in medicine who are concerned that all of these technically remarkable, truly priceless modalities are being used in most inappropriate ways at great cost to the community and, in many instances, to the detriment of patients.There may be