Readers React: Hospitals practice ‘rampant capitalism’? It’s not that simple

To the editor: Dr. Michael Jones describes overly intense, expensive healthcare. This is a very complex issue, but there are some solutions. (“There’s no place for rampant capitalism in treating the sick,” Opinion, May 8)

If you are not paying for something, you are usually not concerned with the cost. We need to incentivize the public to be concerned about cost, perhaps by requiring a copay, to encourage cost-comparisons and competition.

The person Jones says was charged $10,000 for an uneventful emergency room visit was really experiencing cost shifting. Requiring reasonable reimbursement by insurers and the government would reduce the need for cost shifting.

I believe that reforming the malpractice mess could reduce overall costs by discouraging defensive medicine and unnecessary procedures. A no-fault system like workers’ compensation or requiring gross negligence as the standard for lawsuits would reduce defensive medicine costs.

We need to simplify entry into the healthcare system, where a primary care provider takes a history, actually examines the patient, orders only necessary tests and prescribes treatment. Patients should be referred to a specialist only when a higher level of treatment is required.

Arthur L. Wisot, MD, Rolling Hills Estates

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Jones makes several important points about excesses in our healthcare delivery system.

However, he mentions that hospitals order excessive procedures. Hospitals don’t order procedures, physicians do. Jones should be shining the light on his fellow physicians to restrain the use of hospital procedures.

As for hospital billing, it is well known that what is charged is not what is paid. For the most part, each insurance company has its own rate schedule that makes the bill not relevant in the final analysis.

I would say that hospitals never get the full bill paid; they are lucky to get 20% when an insurance company prices the activity. As for uninsured patients, hospitals have a charity care policy that is applied.

It is disingenuous for Jones to compare the fee he “typically” gets to the hospital bill. He should, instead, quote what the hospital “typically” gets for a procedure. I would expect that the $18,000 hospital bill that he references is paid at less than $3,500 for a Medicare patient, probably $2,000 for a Medi-Cal patient and totally written off for some.

Paul Brydon, Malibu

The writer is a retired hospital administrator.

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