Is there a difference between NCFE and Bernard Madoff?

In reference to the article on Lance Poulsen and his COO (Rebecca) Parrett being sentenced to 30 and 25 years, respectively (March 30, p. 4), I believe justice will be served if they are required to remain in prison for the full sentence. In a former position, I became intimately familiar with the agreements utilized by National Century Financial Enterprises with their clients and found the multiple contract agreements to be false and misleading. With overlapping termination dates and fees for each of the required multiple agreements, it was nearly impossible for a hospital, once contracted with NCFE, to terminate the relationship. Finally, the purported 12% interest rate for financing of accounts receivable was really 22% after considering all of the fees, premiums, etc.

The folklore of the “proof is in the pudding by tasting it” was shown when the police seized NCFE; it is reported that 275 hospitals went into bankruptcy. The NCFE was a predator thief stealing from patients, providers and insurance carriers.

In my judgment, there is no difference between NCFE and Bernard Madoff.

Charles Kuebler

Olney, Md.

The increase in Americans who face challenges in accessing healthcare is in part because of the decline in practicing primary-care physicians and to broader physician shortages nationwide (“Millions are ‘medically disenfranchised’: report,” Daily Dose, March 24). The government predicts a shortage of at least 85,000 physicians by 2020. With the growing U.S. population and aging baby boomers, this shortage is one our nation cannot ignore if we want adequate access to healthcare.

Reports of physician shortages have already surfaced in about half the states, but the trend can be reversed. To attract more medical students, the federal government needs to help finance a debt burden that averages $140,000 upon graduation, and create more residency positions. We also need to place a higher value on the important services provided by primary-care physicians. To keep practicing physicians in the office, we need permanent Medicare payment reforms and managed-care reforms to help preserve the patient-physician relationship.

J. James Rohack

President-elect American Medical Association Chicago

From “Why the young are getting restless” (Editorial, March 23, p. 40): “And let’s hope their numbers grow and that the dubious ethics of too many members of the previous generation become a story of the past.”

While we can applaud the transformative attitude of the youthful doctors regarding “Big Pharma, Big Money and conflicts of interest,” I believe that pressures on residents and newly practicing doctors are creating situations that result in novel ethical challenges and lapses. We are writing another chapter that resembles old plots with new twists.

Mary Ann Clemens

Vice president/medical education Advocate Health Care Park Ridge, Ill.

What do you think?

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