On a recent Sunday afternoon, a 75-year-old Philadelphia man with a fever of over 102 degrees was unable to reach his doctor. So his daughter took him to an emergency room, where the two sat for hours until he was examined by a physician who found no reason for the fever and decided to admit him overnight. The man was given oxygen, a chest X-ray, a blood test and, finally, a urine test, which revealed a urinary tract infection. The problem was solved with a prescription for an antibiotic, but at a cost of thousands of dollars to Medicare.