THE DEC. 31 editorial “Tiered coverage, SaveOn plans can boost cost-conscious care’’ espouses tweaks to our failing health care system that won’t change the cost curve but would make it more complicated for patients to obtain medical services. Tiered coverage limits choice for patients who may prefer doctors or hospitals outside their network, and unfairly penalizes patients who can’t afford extra fees to go to providers of their choice. The SaveOn initiative that pays patients to go to less expensive service facilities, even though their doctor may not recommend them, strains the important doctor-patient relationship and raises doubt about the quality of cheaper services.