Governor Deval Patrick has graciously asked for help for ways to rein in Massachusetts’ budget-busting health care costs.

Well, since you asked . . .

Not to say “I told you so”, but this was entirely foreseeable. Any attempt to increase coverage without effort to control costs will lead to no other conclusion.

The only true way to cut costs is to say “no”, and ration care. Government does not have the balls to do that.

The fault lies in a failure to remedy the primary care shortage. Coverage without the ability to find a doctor is worthless. Sure, emergency rooms benefit by seeing more insured patients, but care in that venue is often the most expensive.

Following Medicare’s lead and cutting provider payments will simply lead to an increased number of services, further ballooning costs. Not to mention driving already scare primary care providers into concierge cash-only practices or retirement.

Some have suggesting utilizing mid-level providers. They are certainly useful, but asking them to replace primary care is not the answer. NPs and PAs will readily admit their training is not as comprehensive as a physician’s, which will result in higher specialist and diagnostic test utilization.

Provide incentives that appeal to medical students considering primary care. The NY Times aptly describes the situation students face when considering dermatology versus primary care. The choice isn’t close.

Find ways to keep already overburdened primary care providers from leaving or retiring early.

This isn’t rocket science. The ball is in your court Governor.