The Wall Street Journal reports that doctors at the American College of Cardiology's annual conference voiced concerns about increased pressures on reimbursement for certain procedures. Doctors who perform angioplasty and implant heart stents are concerned about the potential for government moves that could compress reimbursement payments for such procedures, which would in turn hurt device makers. "There's a general concern that reimbursement for hospitals as well as physicians will be under increasing pressure," said Gregg Stone, who directs cardiovascular research and education at the Center for Interventional Vascular Therapy at the New York-Presbyterian Hospital/Columbia University Medical Center. Stone also said this is a long-running worry that changes will drag down salaries, making medicine a less attractive profession. He also noted the potential for worse circumstances, saying he dreads "being in a hospital system that tries to limit the type of care I practice." Stent applications are a particular worry because they are such a reliable cash cow for big players in the device market. According to the journal, "that worry took a toll after the budget proposal was issued on Feb. 26, and medical device stocks haven't reclaimed lost territory despite the market's recent scorching run." Although there has been no government signal about sudden plans to squeeze prices for medical devices, the fear is real. But is the fear justified? I find it difficult to believe that changes to reimbursement would discourage the use of technology that limits the need for far costlier healthcare, which is what stents do. It's illogical. Device makers shouldn't worry about stents unless they are being used on patients that won't benefit from them. As for doctors concerned with being limited in the type of care they practice, haven't HMOs effectively already done that? It seems to me that the thing he is most afraid of is the very problem healthcare initiatives are trying to solve. Am I oversimplifying? Heather Thompson