To the Editor.
—I am an otolaryngologist in solo practice. I have worked within and outside the University of California, San Diego, and have a considerable amount of experience working for the underserved populations in the San Diego region. The conclusion reached by Dr Levine and colleagues1 appears to be to give money to the schools of medicine, public health, and nursing, to give incentives (eg, matching funds) to areas that are providing programs working with the academic centers, to develop reimbursements from taxpayers, and to provide for federal incentives (ie, tax benefits) to businesses that are providing support and money for this new academic initiative. As a frontline physician, I am not impressed that the inclusion of local academic centers does much to bring down costs for medical care in underserved areas.In my experience, I have found that if patients wind up at an academic center emergency