I appreciated your story on controlling healthcare costs, Cost conscious (April 27, p. 18). I would like to point out that many times what we consider costs are really expenditures or prices, and these are outputs of the healthcare system.
These prices are the result of inputs, such as expensive labor, equipment (surgical, imaging), information technology, pharmaceuticals, facilities, etc. My hope is that the discussion on reducing or controlling expenditures, the output, will involve somehow helping healthcare providers deal with the high cost of inputs. Expectations on hospitals are high, and they should be. Trouble is, while hospitals deal with both higher expectations and mushrooming input cost, they are reimbursed less for the services they deliver. The process to even get reimbursed by public and private payers gets more complex every day. Providers are getting pinched in the middle.
My peers and the clinicians I work with are undoubtedly in favor of safer, more appropriate and efficient treatment. After all, we chose healthcare as a career to help people. I feel as though the providers (doctors and hospitals) are caught in the middle of expensive suppliers and labor shortages on the one hand, and complex and wealthy insurers on the other.
What politicians are missing is that insuring everyone just makes the federal government bigger and insurance companies richer. A real solution would address the cost of inputs in the healthcare system and guarantee that at least 75% of healthcare premiums are spent paying providers fairly for good care.
Christopher R. StipeCEO Clarinda (Iowa) Regional Health Center