Doctors Can’t Cure Health System’s Ills
The recent article in your paper that reports a decline in charity care among all physician specialties (“Doctors Less Likely to See Poor Patients, Study Shows,” March 23) contains a glaring omission: 100% of ER doctors are seeing ever-increasing numbers of uninsured patients, 24 hours a day, 7 days a week -- and the care that we provide is almost completely unreimbursed.
The problem is not that physicians are less charitable. The problem is that our county and state governments are trying to balance their budgets on the backs of the poor.
Dr. Mike Salomon
American College of Emergency Physicians
Modesto
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It should be obvious to anyone that the entities consuming the biggest portions of the healthcare money pie are the insurance executives and the pharmaceutical companies.
While reimbursement for our services is declining every year, our overhead expenses are driven up sky-high by rising malpractice premiums, employee compensation and ever-more-complicated federal and local mandates, which do not take into consideration the extra cost involved, plus a whole host of office expenses.
I am very proud that up to two-thirds of my colleagues are willing to treat these [poor] patients. Our healthcare system is broken, but as long as the insurers are making their big bucks and the legislators are getting huge campaign contributions as payback, I am afraid that there is nothing an average citizen can do.
Dr. John T. Chiu
Newport Beach
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Doctors, hospitals and patients are caught between a rock and a hard place when it comes to caring for the uninsured. This despite spending 15% of the world’s biggest gross domestic product on healthcare.
High-deductible, low-coverage plans will only increase the number of people showing up in doctor’s offices for care that is not reimbursable -- or, even worse, people will delay care.
There are bright spots. Thanks to innovative partnerships, two community clinics that were closed because of county budget cuts have recently reopened, and Medi-Cal managed care plans have kept many doctors serving low-income patients.
But the system remains dangerously fragile. Charity care isn’t going to fill the gap as the employer-based system of insurance continues to melt away.
It’s time for everyone -- legislators, employers, health plans, insurers, doctors, consumers and advocates -- to work together and develop a creative solution.
Howard A. Kahn
Chief Executive
L.A. Care Health Plan
Los Angeles
