Industry needs to focus on technology, treatments that add value, and other letters

Regarding the April 21 cover story (“Surgical-robot costs put small hospitals in a bind,”), if there were randomized, prospective trials demonstrating clear superiority of robotic techniques over conventional surgery, there would be an unambiguous rationale for the use of robotics. It would be a competing technology with a clinical benefit.

However, except for retrospective studies demonstrating a day or two advantage in length of stay, such evidence is lacking, and this technology has become a competitive tool for hospitals in terms of driving volume, which of course, (with the added expense of utilizing the technology without additional reimbursement), is the primary reason that hospitals purchase it.

When we compete for patients and the reimbursement that accompanies their treatments and procedures (rather than competing to see who can deliver the best care and outcomes), we perpetuate the morass that our healthcare industry has become. When we begin to compete on the value of the care that we deliver, we will realize that procedures that cost the system (including patients) more without added benefit have no place in an efficient healthcare system.

Dr. Robert Lancey

Regarding the April 21 editorial (< a href="http://www.modernhealthcare.com/article/20140419/MAGAZINE/304199983">“The ACA's midterm report card,”)—not so fast on giving Obamacare a passing “C+” grade. As Democratic U.S. Rep. Stephen Lynch of Massachusetts has correctly pointed out, much of the law's pain has been delayed. When employer plans begin to be taxed or disappear, and with employers unloading workers onto restrictive, narrow provider networks, the electorate will give incumbents another whipping. President Barack Obama has ensured that only the sugar is dispensed on his watch. The medicine will come later.

Alan Muratet