There really is a doc shortage and other letters

I wish to dispute your article “What doctor shortage?” (Nov. 11, p. 14). Because of the many inequities in healthcare payments and the realities of practicing along the Texas-Mexico border, we are understaffed! And we will be for a long, long time. Please come and see. Then report on our issues.

Dr. David M. Palafox

I appreciate the Nov. 4 editorial (“When keeping what you have means ignoring those who don't,” p. 26) educating Modern Healthcare readers about the “first principles” behind the health insurance reforms in the Affordable Care Act.

For many years, I have been self-employed, maintaining an individual health insurance plan with a large carrier. Yes, the plan was “far more expensive than similar coverage in an employer-based plan,” with its high deductible and monthly premiums. For the past 10 years, annual increases averaged 18% to 20%.

However, the plan did not provide “skimpy” benefits. With no pre-existing conditions when I purchased the plan, I chose to pay for a comprehensive plan that provided coverage for serious illnesses, including emergency room and ambulance care, mental-health benefits, MRIs with authorization and other good benefits.

Yet, on Oct. 1, I, too, received a letter explaining that my plan was being canceled because it did not conform to the ACA reforms. None of the new plans offered included any “reductions in premiums.” In fact, they included another yearly increase of about 18%. To date, I haven't found any similar alternatives, even on the exchange for my state.

All this confirms the conclusions about healthcare reform I have had for years. It is not about the delivery of healthcare or the services (although improvements always can be made regarding patient safety, tort law, etc.). It is about the convoluted and uber-expensive, third-party reimbursement of healthcare that needs reforming.

Deborah Kohn