Re "Medicare's Faint, Faint Pulse," by Thomas LaGrelius, Commentary, Feb. 25: As a retiree who has paid into Social Security all my working life, and to fund Medicare since its inception in 1965 so I could have Medicare benefits when I reached 65, I am incensed by doctors like LaGrelius and Senate Majority Leader Bill Frist (R-Tenn.) who want to break a solemn covenant made to me and millions like me. We were promised Medicare by Congress, and Congress has a moral and legal obligation to honor it with us. LaGrelius says: "There is not enough money in the universe to pay for Medicare's future as it is now structured." He is wrong! There is enough money, and it is all right here in the U.S.
The reason Medicare is running out of funds is due to doctors who have milked it as a cash cow since its inception. Most physicians in this country do not practice cost-effective medicine, sending patients for unnecessary testing, performing unnecessary elective surgeries, prescribing medications when they are not needed and using the newest brand-name drugs when no controlled "head-to-head" studies have ever been done to compare their efficacy and safety with older, far less expensive generic drugs. There are also other reasons for this behavior by physicians, such as practicing "defensive medicine" out of fear of malpractice lawsuits. But I believe the main reason for their behavior is lack of proper training to allow them to use the time-honored skill of good clinical judgment.
Fred L. Lieberman
LaGrelius complains that Medicare does not pay him enough for office visits and says his patients would rather pay the usual fee to a doctor who has "opted out" from Medicare. It is true that some of the elderly can afford it, but they surely cannot afford the hospitalizations and other care that Medicare covers, and LaGrelius' patients use, when office visits do not suffice.
The fact is that Medicare -- though derided by doctors, hospitals and most of the providers because of the low reimbursement rates and, admittedly, other deficiencies -- is the universal health insurance in this country that covers the elderly and disabled. Besides Social Security, this is the most cherished entitlement program; the providers, including doctors, had better appreciate this and, instead of dropping out of it, work on how to improve it.
Gabor Tamasi MD