Sunday, October 07, 2007

LTE: October 6, 2007

The tone of Dr. Charles F. Hesse's October 6, 2007 letter to the editor, "Medicare-type insurance penalizes providers," makes the good doctor appear as if he is more concerned about his bottom-line than the health and well-being of his patients.

Yet Dr. Hesse's letter would not seem so whiny and self-serving had he mentioned the reason for his ire, the Medicare Modernization Act of 2003 (MMA) that, then, had the support of the American Medical Association.

Medicare payments to physicians for traditional Medicare Parts A and B have remained stagnant since 2001. This in itself is bad enough. But according to the AMA itself it is Medicare Advantage plans in which benefits and payments are administered by private healthcare insurance companies that are short changing both patients and physicians.

In May of this year the AMA reported that a survey of its members found than half that the patients with Medicare Advantage HMOs and PPOs were denied services typically covered by traditional Medicare. The same survey also reported that 51 percent of its doctors received lower payments from Medicare Advantage plans than from traditional Medicare.

But for the healthcare insurance companies which handle Medicare Advantage plans the federal government picks up the enrollee's monthly premium to the tune of $800 to $2,000 a month.

Dr. Hesse concludes by advising Des Moines Registers readers to visit the American Medical Association's Web site for "an intelligent solution to the health-care dilemma." Among the AMA's proposals are a national cap on medical malpractice law suit awards and shifting the burden of health insurance ownership from employers to individuals. It is little different than the so-called "universal" healthcare plan forwarded by Democratic presidential hopeful Senator Hillary Clinton and keeps the private sector in the mix.

Perhaps Dr. Hesse should be asking why a private healthcare insurance company, answerable only to its major shareholders, is better than a single-payer healthcare system which, if the government is properly functioning, is accountable to the voting public?

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