Rethinking Health-Care System
Consider how much better our health-care system could work if it were divorced from employment (“Radical Surgery Is Needed on the Way America Finances Health Care,” James Flanigan, Nov. 10).
If we could roll the clock back 60 years and start fresh, we’d never, knowing what we know now, make employment the nexus for health insurance.
Notwithstanding the theoretical interest employers have in the health of their employees, virtually all employers who offer health insurance would rather be free of that responsibility.
The negativity associated with the era of managed care is a byproduct of the desire of employers to become disengaged from the expense and the problem-laden aspects of providing employee health insurance.
Jim Duncan
Buena Park
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The only viable option for salvaging health care is a federally administered single-payer system. Companies such as PacifiCare Health Systems Inc. are part of the problem, not the solution.
Why should health-care resources go to corporate profit and double-digit overhead when Medicare operates with an overhead of 2%? Most industrialized countries enjoy better health care than the U.S. by spending 8% to 9% of GNP in single-payer systems, while we waste 15% of ours on a system that provides no care to 41 million and insufficient care to many more.
Dr. Gerald Gollin
Redlands
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I am a registered nurse with 20 years of stories to tell that can rival what has been reported about Tenet Healthcare Corp.
This is just the tip of the iceberg. Tenet is not alone. Just about every hospital I have worked at overdoes everything. The public has been sold a myth that there is a shortage of health care.
Unnecessary tests, procedures and medications are symptoms of a third-party-payer system and an ever-increasing population of people in our socialized medical programs.
Kathryn Ellison
El Segundo
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As an employee of Tenet (not a spokesperson), I would like to correct your perception of this particular issue.
Hospitals, including Tenet, do not bill specific amounts to Medicare for outliers [special Medicare funds that are paid to hospitals for unusually costly procedures].
The payment amount is calculated by Medicare’s fiscal intermediary and has absolutely nothing to do with the amount billed.
Medicare uses the hospitals’ cost reports from two to three years earlier, or the statewide average, to determine reasonable and customary charges.
Are Medicare outliers a quirky bureaucratic process? Absolutely.
Did Tenet raise charges to all payers equally over several years to combat declining reimbursement managed-care contracts? Yes.
Did this have an unintended effect of altering Medicare’s outlier calculation? Yes.
Does Tenet have a serious PR issue to overcome? Yes.
Has Tenet overbilled or aggressively pursued or boosted outlier payments? Absolutely impossible.
Jason Petrasich
Laguna Hills
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I think you have succinctly identified a chunk of the problem. Longevity does increase costs of treatment. So do health-care advances in the form of new drugs, new tests and new treatments.
Every advance expands the testable and treatable patient base. More tests, more treatments, higher costs.
R.C. Phelps
Kalispell, Mont.
