In Sen. (John) Kerry's campaign for president, he makes a point that healthcare insurance costs have risen "11% under the Bush administration." Now is our opportunity as healthcare providers to remind Kerry (and the voters) that medical malpractice liability costs have made up most, if not all, of that because he and his good friend Sen. (Edward) Kennedy, both in the hip pockets of trial lawyers, have blocked administration-backed tort reform in the last two sessions of Congress.
C. William Spencer Arlington, Texas
Understating the obvious?An open letter to Robert McGowan: The following quote was attributed to you in an April 21 story on ModernPhysician.com ("Surprise, surprise: Docs, administrators see things differently") by Joseph Conn: "Unless physicians and hospitals can find better ways to align their mutual economic interests, there will be some serious breakdowns in the future."
Were you understating for effect? The future you speak of is now. Hospitals and physicians are at each other's throats across the country. The potential for adverse effects on patient care, as well as increased costs to our healthcare system--which patients ultimately will be asked to bear--are obvious. I suggest that the problem of conflict, rather than cooperation, between physicians and hospitals needs to be recognized and treated as the immediate threat to our healthcare system that it represents.
W. Harry Horner, M.D. Waynesboro, Va.
You've got a hit in HITSI just finished reading your inaugural issue of Health IT Strategist (HITS). If it is any indication of what is to come, I think you have a winner. The depth of the information presented and back-up documentation was excellent. Keep up the good work.
Jim McGillis President 1st MedWest Westlake Village, Calif.
The real issue is conflicts of interestIn your February 2004 edition of Modern Physician, the former publisher, Clark Bell, wrote a commentary ("Legal interference," p. 9) about specialty hospitals.
In this editorial and others, your position continues to be that the market should decide winners and losers in healthcare, that the American system was built on free enterprise and competition, and that should work for hospitals. We all know that the free market is very good at selecting winners from losers. It also is much less adept at allocating social responsibility. And while a large part of our healthcare system clearly is and will continue to be market-driven, the social responsibility for taking care of the uninsured continues to fall on the general acute-care hospital. As long as this is the case, fair competition between those with equal circumstances is clearly not present.
But setting that aside for the moment, it seems to me the real issue that you have missed is the one of conflict of interest. Hospital administrators can and have gone to federal penitentiaries for encouraging physicians to admit patients to their hospitals. Your magazine needs to explain how that is different from physicians who financially gain from admitting patients to hospitals that they own.
It seems to me that we have an ethical conundrum. Either you need to editorially call for the elimination of restrictions on acute-care hospitals? incentivizing physicians to utilize their facilities, or you need to support the efforts of the American Hospital Association to eliminate this conflict. You simply cannot have it both ways. And I suspect that our industry would support either.
Stanley Hupfeld President and chief executive officer Integris Health Oklahoma City