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NAVIGATION PNHP RESOURCES
Posted on October 16, 2007

Blame private firms for health-provider losses

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Letter to the Editor
Des Moines Register
October 15, 2007

The tone of Dr. Charles F. Hesse’s Oct. 6 letter, “Medicare-Type Insurance Penalizes Providers,” makes the good doctor appear as if he is more concerned about his bottom line than the health of his patients.

Yet Hesse’s letter would not seem so self-serving had he mentioned the reason for his ire: the Medicare Modernization Act of 2003 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, it is Medicare Advantage plans, in which benefits and payments are administered by private health-care insurance companies, that are shortchanging both patients and physicians.

In May of this year, the AMA reported that a survey of its members found that half 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.

Hesse advises Register 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 awards and shifting the burden of health-insurance ownership from employers to individuals. It is little different than the so-called “universal” health-care plan forwarded by Democratic presidential hopeful Hillary Clinton.

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

Bob Jewett
Des Moines