As a practicing physician in St. Paul and president of the Minnesota Medical Association, the largest professional organization of physicians and physicians-in-training in the state, I read with great interest the recently reprinted St. Louis Post-Dispatch editorial regarding the role of payments to U.S. physicians as a driver of higher spending ("America's medical markup," Sept. 20).

The cost of health care deserves attention -- it is too high, is growing too fast and is unaffordable for too many. Medicine can be a very rewarding profession, personally and financially.

But medicine must compete with many other well-paid professions for the brightest minds in order to advance science and provide high-quality, compassionate care.

International comparisons, as provided in the recent study that was mentioned in the article, can be informative and useful, but do little to fully define the issue or offer solutions.

A focus on physician income as a significant contributor to the high cost of health care misses the mark. The opportunity we have is in examining total health care spending, understanding the real drivers of that spending and considering what we can do about it here in Minnesota.

Here are a few facts. In Minnesota, for every dollar spent on health care in 2009, only about 20 cents was spent on physician services. Of those 20 cents, approximately half was used to pay for practice expenses, such as support staff, malpractice insurance and other overhead.

More than 80 cents of every health care dollar is spent elsewhere -- on inpatient and outpatient hospital services, prescription drugs, long-term care, and by insurance companies on their administrative costs and earnings.

Compared with the entire country, Minnesotans spent nearly $700 less per person annually on health care ($6,900 compared with $7,600).

We also know that the cost of health care is highly concentrated -- about 5 percent of the population is responsible for nearly 50 percent of all spending.

In addition, spending increases dramatically with age -- with average spending for individuals between the ages of 55 and 64 more than three times the spending for individuals 25 to 34 years of age.

It is not too hard to imagine the impact on the cost of health care as the baby boomers hit retirement age.

So let's focus our attention on these facts. As a society, we need to look at where the health care dollar is spent and make decisions regarding the value received for the money spent. We need to invest in prevention programs to stop the onset of expensive, complex, chronic conditions.

We need to make it easier for patients to manage their conditions -- to take prescribed medications, to complete therapy, to exercise regularly. We need to eliminate administrative waste, duplication and complexity. We need to fight fraud and abuse.

We need to provide appropriate care, not unnecessary care. We need to continue to innovate and experiment with new care-delivery models, and we need to pay for care in ways that support good outcomes.

Solving the complex problem of the high cost of health care warrants a comprehensive approach and will require multiple solutions. Physicians play an important role in delivering high-quality, cost-effective health care.

The Minnesota Medical Association will continue to lead efforts to draw attention to needed improvements in Minnesota health care. We all have a role in helping control health care spending.

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Lyle Swenson is president of the Minnesota Medical Association.