Last week, I received a form letter from my internist's office, spotlighting one of the more peculiar characteristics of our health care system.

It began:

Dear Patients:

As many of you know, Medicare does not cover preventive medical care or annual physical examinations. Comprehensive annual examinations are a very important part of your health care, allowing us to focus on prevention of illness and patient education.

Due to increased Medicare scrutiny of its regulations, with audits and threats of sanctions against doctors, we can no longer bill preventive care as office visits. We must follow Medicare guidelines and code them as preventive medical examinations. These visits, though allowed and encouraged by Medicare, will not be reimbursed financially by Medicare. ...

And on it went, urging seniors to continue getting annual check-ups, despite the $275 cost that Medicare will not cover.

My initial thought upon reading this letter was how odd it was that the practice was officially announcing that it would no longer be gaming the system.

My second reaction was how counterproductive the broader Medicare policy seems--especially with everyone talking such a good game about how our health care system needs to place more emphasis on healthy living and prevention. (And, let's face it, the older you get, the greater the odds of something going wrong and thus the greater the need for keeping close watch on everything.)

I realize costs must be contained and limits must be set. But I'm far from convinced this is the wisest area to focus on.