GOP health plan proposal sounds like more of the same, and other letters

In response to the recent article "GOP's health plan takes shape": In other words, the GOP continues to be bereft of plausible alternatives. Just more of the same tired talking points, i.e., tort reform, which is a red herring, and other vague concepts, as noted in the article.

I am still amazed at how many conveniently forget that “Obamacare” was originally the brainchild of the conservative Heritage Foundation in response to “Hillarycare” in the 1990s.

Margaret Houlehan

After reading the article "CBO lowers 2014 insurance enrollment estimate by 2 million, citing exchange rollout woes", are we really to believe the government is providing the truth in those statistics? Dream on.

I thought Obamacare was to reduce the number of 30 million uninsured. Now, it's projected that we'll still have that many uninsured. What a mess.

Dr. John Pfenninger

As a physician and healthcare consultant, I agree with Susan Frampton, president of Planetree, based on her recent op-ed, "Don't let lack of evidence delay patient-centered changes".

Strengthening the argument, multiple studies have shown that patient-centered approaches improve patient care. In addition, by focusing on high-cost/high-risk patients, self-funded organizations can make a significant difference in the reduction of healthcare expenses and in the improvement of care.

We need to keep in mind that high-cost/high-risk patients, who represent the top 1% to 5% most-expensive enrollees in a health plan, account for 25% to 50% of the healthcare costs, according to the IMS Institute for Healthcare Informatics. The average cost for a patient in the top 1% is more than $100,000 a year. These costs can be reduced through careful patient-centered care, such as outpatient care as part of a patient-centered medical home. For example, a 2012 AHRQ/HHS report (Early Evidence on the Patient-Centered Medical Home) summarizes that the Geriatric Resources for Assessment and Care of Elders (GRACE) model realized 23% savings for the high-risk group (compared with a control group) in the post-intervention year after two years of intervention, which were initially cost-neutral.

Since laws and regulations vary depending on health plan type, appropriate legal compliance needs to be addressed before implementing patient-centered care in any health plan.

Patient-centered enhanced care is an important tool to help improve the care of high-cost/high-risk patients while simultaneously achieving savings.

Dr. Moshe Ziv

Regarding the recent article "Providers push for further delay of two-midnight policy", the Patient Protection and Affordable Care Act does not go far enough to protect the patient. Healthcare providers should be required to post patients' rights and include where to file a complaint, make suggestions or comments and provide the forms to do so.

Being hospitalized for five days with an infection, I kept some notes and afterward sought a department that would review the treatments I was given. The Michigan Department of Community Health said there is no such agency. My doctor, who was not affiliated with the hospital, told me afterward that I was overmedicated.

Health providers are switching from paper to electronic health records. These records should be kept indefinitely. They should be kept in a timeline, listing treatments and medications in the order they were given. This may reduce unnecessary tests and may keep the patient from being over-medicated.

All medical bills should have a reference number that would be used by the healthcare provider, insurers, lawyers and collection agencies. The bills would include treatments and dates of service. This would reduce double payments and give the patients a clear understanding of what the charges are for.

Gary Kujat