Excerpts from the Globe’s health care blog.

Health care quality and safety fall “substantially short of their potential,” says a report from the Institute of Medicine, and there are major disparities in how different populations across America are treated.

The report, “Best Care at Lower Cost: The Path to Continuously Learning Health Care in America,” delves into the health care industry’s big challenge, hitting on common themes of overspending and quality of care. The biggest cause of waste is unnecessary care, including overuse of high-cost services, totaling about $210 billion in 2009, the report says. Today’s approach to paying hospitals and doctors for each test or treatment “encourages wasteful and ineffective care.”

One highlight is this summary of just how different health care is:

■  If banking were like health care, automated teller machine (ATM) transactions would take not seconds but perhaps days or longer as a result of unavailable or misplaced records.

­■  If home building were like health care, carpenters, electricians, and plumbers each would work with different blueprints, with very little coordination.

■  If shopping were like health care, product prices would not be posted, and the price charged would vary widely within the same store, depending on the source of payment.

■  If airline travel were like health care, each pilot would be free to design a preflight safety check, or not to perform one at all.

Readers react to an MD’s 200-pound ruleDr. Helen M. Carter of Worcester caused a stir last month with reports of her plan to turn away new patients weighing more than 200 pounds, citing injuries to staff and financial issues. Readers had a lot to say about it. Their comments generally opposed the rule.

Others questioned the logic and legality of the rule. Kat2010 wrote:

I’m wondering how the screening works? Unsuspecting Potential Patient: Hello, I’m a new patient and would like to make an appointment. Secretary: You don’t weigh more than 200 lbs. do you? Unsuspecting Potential Patient: Uh, why is this relevant to my head cold? I weigh 205. Secretary: “Click.”

I wish this doctor luck. Sometimes weight gain/loss is actually a medical issue, but obviously nonroutine medicine is above this doctor’s pay grade. Her patients should take notice.

When I was talking with friends, we all wondered: Why 200 pounds? Tall, muscular people can easily weigh more than 200 pounds. Patriots quarterback Tom Brady, for example, weighs 225. PeregrinesBoat raised this issue:

So BMI and height mean nothing? I know someone who weighs 250, 6-foot-four, solid and healthy . . . I know someone who is 140 lbs. and almost spherical in shape. In a free market at least we are free to go to other doctors, ones who do not prediagnose with their prejudices.