To the Editor.
—Dr Gleicher's article1 about the issues of cost control in medical care contains summary conclusions, which do not address the assumptions that underlie the present crisis; rather, they are typical of the thinking that has led to it."Good medical care" is not anyone's "right." It is a privilege. Further, the assumption that everyone deserves identical medical services, rich and poor, responsible and irresponsible, underlies our inflexibility in the face of our fiscal crisis.The medical community should not agree to any type of fiscal manipulation. We have a market economy and antitrust laws to determine the prices and availability of services. Indeed, what is needed is less regulation of health care provision, not more.As regards the issue of "standards," if Gleicher wants to criticize the Joint Commission on Accreditation of Healthcare Organizations and similar organizations, he should do so directly. I think their goals