I read with interest the article on the politics of health premium costs, "Who's to blame?" (Sept. 13, p. 8). I have worked in the healthcare industry for nearly 20 years. For a large part of my tenure, I have developed and managed provider networks for health plans in Colorado. With those credentials, I believe I know what I am saying.
I want to take issue with the assertion that the high (and rising) cost of healthcare is attributed to government malfeasance, provider charges or pharmaceutical costs. I'm not saying that these factors don't contribute to the increase in healthcare costs, but provider charges and pharmaceutical costs are dwarfed by other causes.
Far and away the greatest cause for the increases in healthcare costs is that our population is getting older. It's common knowledge that seniors use healthcare services more often and the services tend to be more intensive. It is rarely mentioned, however, that this population is not being offset by an infusion of younger people into the population who would pay for premiums but not use many healthcare services. The reason there is not a renewing of younger people is the reduction in fertility rates and the fact that 44 million abortions have occurred since 1973. It's the truth.
A second reason is the litigious state of our society. When lawyers and opportunistic individuals think they are hurting health plans and providers with frivolous lawsuits, they ignore the reality that the cost of these lawsuits is passed directly to the American consumer through higher premiums. I am not denying that there are cases of legitimate medical malpractice lawsuits, but they represent a minority of all medical lawsuits.
The final major reason for the increase in healthcare costs is the fact that the American consumer is disconnected from the true cost of healthcare. When consumers don't have to pay the cost of healthcare, they overuse services. Health plans have done a great job of shielding the public from the true cost of healthcare. The average American has no idea what a positron emission tomography scan costs or what a day in the hospital costs. If they did and had to pay full freight for more of the healthcare they use, they might take the time to consider whether or not they truly need the services.
More reporting needed
I enjoy Modern Healthcare for its reporting on most health-related issues, but implying that the only rational discussion of embryonic stem-cell research will take place postelection or that Americans will dismiss moral concerns when a cure is found through this research reveals a certain bias ("Special report: Election 2004," Nov. 29, p. 24). While honestly pointing out that embryonic stem cells are "harvested from embryos," your article failed to report that the human subjects are ultimately destroyed.
The article goes on to quote only persons clearly supportive of embryonic stem-cell research, while neglecting a full treatment of the topic, adding to the confusion over the underlying scientific and moral dimensions of the subject.
A more thorough presentation of this issue in Modern Healthcare in the future would be helpful, and I would be happy to assist you in that effort.
Associate for health
Florida Catholic Conference
I applaud your cover story on temporary healthcare managers ("For a limited time only," Oct. 18, p. 6). I agree that this new breed of interim chief executives is rapidly increasing in popularity. Lowell Johnson and Bruce Nielsen, whom you profiled, are both men whom I'd like to work with/for.
Clinical nurse consultant
Franklin Medical Center
What do you think?
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