But Dr. Chassin said: "If you established a global budget for health-care expenditures in New York State, I wouldn't have any clue how to administer it.

Between 2002 and 2004, health-care expenditures in the national budget increased from 3.8 percent to 4.3 percent, with the NHIF accounting for more than 60 percent of annual expenditures.

There is about a 75:25 percent ratio of public to private health-care expenditures.

I wasn't defending small health-care expenditures.

Unfortunately, the reform bills that Congress has passed don't tackle some of the system's underlying problems, such as the lack of incentives to limit health-care expenditures.

"We're seeing double-digit inflation in insurance premiums right now, and growth in total health-care expenditures is starting to approach that level."

This is one reason, you say, that health-care expenditures rose 17.1 percent last year.

The Administration's four-year failure to introduce a health-care plan incites skepticism, as does the vagueness of Mr. Clinton's proposed cap on health-care expenditures.

One more absurdity of our market-based system: the pressure is to increase total health-care expenditures, not reduce them.

"The capping of health-care expenditures is far less of a concern to me as a physician than to my patients."