It’s time to pass reform bill, a reader says—but not all readers agree
As a junior researcher who is interested in the phenomenon of the emergence of new hospital organizational forms, I agree with all the points you discussed in your article “Up-sizing the competition” (Feb. 15, p. 22).
I have written my dissertation on specialty hospitals and much of my research is focused on this organizational form.
It is really amazing to me how the government can interfere to ban a potentially more efficient competitive form of hospital, just to protect general hospitals, even though 75% of these general hospitals are already getting favorable treatment through tax exemption.
Much more research is needed on physician-owned specialty hospitals and banning them prematurely is an institutional failure that will severely hinder current efforts to
improve the quality and efficiency of our healthcare system.
Mona Al-Amin Assistant professor Health Services Research Management and Policy Department University of Florida Gainesville
Trade arrogance for needs
I think the action of our legislators is deplorable—including the Obama administration (“Obama to announce direction on reform next week,” ModernHealthcare.com, Feb. 26).
Congress has completely mismanaged the Medicare and Tricare programs, which are so important to the health and wellbeing of Americans who have served our nation so long and so well. Our representatives had:
■ More than a year to repeal the Medicare payment formula and ensure the security and stability of the program. Instead, Congress has abandoned patients who rely on Medicare and Tricare for their healthcare.
■ Parliamentary procedures offer no excuse for the harm they are causing these programs.
■ They need to stop playing political games with patients and physicians; the sustainable growth-rate formula should be repealed once and for all.
President Barack Obama needs to exchange his arrogance for thoughtful consideration of the needs of the people he represents.
Patricia L. Brewster CEO Southern Orthopaedic Specialists Atlanta
I find those suggesting anything other than moving forward promptly on reform heartless. We have been at this for decades. Tens if not hundreds of thousands have died unnecessarily because they could not afford care. Countless families have suffered bankruptcy because of unfair healthcare cost burdens. Every other civilized country in the world has figured this out. It’s way past time for the U.S. to pass major reform.
I pray that the Senate and Congress will gain compassion, put aside their power-grabbing show and work out a reform bill.
Ned Simpson Ann Arbor, Mich.
Get it together
I f the Democrats are serious about passing a bipartisan healthcare system overhaul law, they need to incorporate the following into the current bill:
■ Tort reform: Arbitration is common to most contracts, so why not healthcare services?
■ Sale of insurance across state lines: Competition can’t hurt.
■ All “special deals” must be culled out of the bill.
■ Honest funding mechanisms: Strong use of dedicated revenue streams.
■ Be willing to limit the bill to a more manageable scope, drastically reducing its complexity.
If the Republicans are serious about helping to solve the U.S. healthcare cost issue they will:
■ Concede that the current healthcare insurance system needs serious improvements.
■ Allow that the current bill appropriately amended could be acceptable to everyone.
■ Help identify ways to fund healthcare services for those who can’t afford it on their own.
The Democrats are justifiably leery of the time delay necessary to seriously consider Republican healthcare reform ideas. The Republicans are pushing to “start from scratch.”
This is overplaying their hand; they should be willing to concede that the main components of the current Senate bill would be retained and improved. It is a shame because together they could craft a bill that furthers everyone’s goals of increased access to healthcare coverage and reduced long-term costs.
Frank Yacano Boston
Utopia, Washington, D.C.
I think it is absolutely absurd to allow the sustainable growth-rate vote to come three days before a potential 21.2% cut in Medicare allowables. I am appalled that a panel can spend six to seven hours talking about healthcare reform, and leave thousands of healthcare workers wondering if there will be layoffs because of this cut.
It is extremely arrogant on the part of the president and his colleagues (both Democrat and Republican alike) to waste one day of Senate legislative work to discuss healthcare reform without the SGR even being discussed on the Senate floor. I find it insulting that after two weeks off (one because of poor weather) the Senate feels it can treat people this way.
These politicians better start to realize that the people are fed up with their arrogance. What do they care when they have all the healthcare perks that no one else has? They had better get out of their ivory towers and enter
the state of reality the rest of us are living in.
What’s so different about an insurance company denying coverage for a surgery when the patient is on his/her way to the operating room? The clock is ticking, but I do not really believe that we all use the same clock as those who are in the utopia of Washington, D.C.
Tom Dahl Chief administrator Orthopedic Center of Florida Fort Myers
The ruse they use
This proposal is merely the latest ruse by the White House and the Democraticcontrolled Congress to get a bill—any bill— passed, so that they can use it as a camel’s-nose-in-the-tent for further one-sided initiatives.
The reforms that we need most are: Do away with the use of pre-existing conditions as a means of eliminating “problem” patients/insured lives for insurance companies. Prohibit policy rescission by insurance companies. Remove the restrictions on how health insurance can be purchased, i.e., per- mit out-of-state competition. We absolutely must have tort reform to control healthcare costs. Finally, we must get “real” and eliminate deals between the Obama administration and special-interest groups—which are all pigs at the trough.
Dennis Tolman Rexburg, Idaho
What a waste
When is someone at CMS going to do something about the completely arbitrary and very wasteful three-day obligatory acute-care stay to qualify for skilled-nursing-facility placement (“MedPAC pressing plan to recoup payments,” ModernHealthcare.com, March 1)?
As a former acute-care hospital director of utilization management turned healthcare attorney, it is one of the many wasteful and archaic requirements in the Medicare program. Numerous patients are “admitted” to the hospital, placed on intravenous antibiotics, and then remarkably discharged to a skilled-nursing facility after the third qualifying day.
(And make sure one of those three days isn’t listed as “observation status” because then the CMS may qualify the entire skilled-nursing-facility stay.) This well-intentioned mandate no longer works in today’s healthcare system.
Frank E. Biedak Lawyer Taunton, Mass.
Competition is good. Is anyone old enough to remember when AT& T had a monopoly (“AMA report finds little competition in insurance market,” ModernHealthcare.com, Feb. 23)?
Unfortunately, today the choice of the plan is higher cost with fewer benefits. Good for some insurers, whereas return on investment is increased. However, fewer benefits at a higher cost are bad for the insured needing care.
Gabriel Mitchell Chicago