Quality argument will be tough to make in debate over narrow networks, and other letters

In response to the March 17 editorial (“The coming assault on narrow networks”), it's going to be tough to make the quality argument stick as long as the quality metrics shine on providers who can cherry-pick patients, and rain on disproportionate-share hospitals. Just look at the disgruntlement with the federal No Child Left Behind Act's effects on education, if you want to see where this is headed. The right and left alike will be opposed.

Bill Baar

Campton Hills, Ill.

Regarding the article “Castlight IPO blasts off with price transparency tech”, I was delighted to read about an upcoming company offering products that provide needed transparency within the medical field.

For far too long, hospitals, doctors and health insurance companies have coveted their cost/profit ratio formulas and not shared them with the very customers/patients whom they serve.

Patients need full transparency regarding cost comparisons for each medical procedure throughout the U.S. They are entitled to have full knowledge of the who, what, when, where, why and how of their medical-related bills.

Scott Kennedy

Burbank, Calif.

Regarding the article “Revised NCQA standards still focus ed on process, critic says", unfortunately the changes in medical-homes standards desired by Francois de Brantes would make the care provider responsible for the patient's behavior in the long run.

Thus, if a patient continues to smoke, despite efforts to stop, and dies of lung cancer, the provider would be downgraded. If a congestive heart failure patient loaded up on salt, despite instructions on salt avoidance, and showed up at the ER in fulminant CHF, the provider would be downgraded.

These types of measures will probably be quite successful in having “noncompliant” patients dismissed from practices, instead of receiving the more-intensive, but more-expensive, care that may be needed for true behavior changes to occur.

Dr. John Stokes

Chairman, department of endocrinologyChristie ClinicChampaign, Ill.

Regarding the article “Physician assistant, nurse practitioner workloads expected to increase”, smart doctors will have several NPs on staff. They help grow their practices. NPs' skills can add to the clinic's revenue, so it can be a win-win for the clinic. NPs and physician assistants also help the clinic provide professional care to many more patients. Wake up, doctors, and look at the reality of the gift you are being handed.

Lynnette Long

Victoria, Texas