Sometimes you scratch your head and do not know what to say. The thinking of the federal agency that administers Medicare is profoundly perplexing. During a meeting today, I found out that Medicare will not pay for the cost of an injection performed in my office. In other words I can give an injection of antibiotic, but medicare considers my cost of ordering, buying and dispensing the injection a normal part of an office visit. So when a patient comes with a skin infection, requiring an antibiotic injection. I can give an antibiotic injection ( but will not be paid for the cost of that injection) or I can send them on to the emergency room where they can get an injection. In their infinate wisdom, Medicare will pay the hospital for the cost of the antibiotic injection (when given in the Emergency Room). The cost of an Emergency Room visit to Medicare is around $300 and my visit costs Medicare around $50. Why spend $50 when you can spend $300. The fortunate Medicare patient can spend less than an hour in my office and spend half a day in the Emergency Room. Lets see, what would I chose. You might begin to understand my concern about a federally mandated health insurance system. Our president and congress was elected to bring Change. It is change, but does it make sense?