Medicare's decision to follow in the footsteps of some insurance companies with an experimental "pay-for-performance" program may not go over well with patients and doctors alike, but it may be the only way to avoid more drastic cost restraints, says David Wessel in this Wall Street Journal editorial. The program rewards doctors with bonuses if total spending on patients decreases while level of performance improves, but many may be uncomfortable with the idea of penny-pinching in health care.

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