'Hospital CEOs still showing same parochial concerns' and other letters

Regarding the article "Healthcare CEOs have zipped their lips on AHCA politics" (ModernHealthcare.com, May 23), I do think the CEOs of major hospital systems, the American Hospital Association, health insurers and physician organizations should be leading the discussion on the repeal and reform of the Affordable Care Act.

Part of the problem, however, is that hospital CEOs were on the wrong side of the debate leading to the ACA's passage. They lost all credibility with the public taking a position that simply gilded their balance sheets without regard to the elemental issues that must be grappled in any true healthcare reform legislation. Today they continue to have the same parochial concerns and are expressing a hysterical fear they have learned from their progressive mentors.

David Beauregard

Managing director

Monument Square Advisors

Richmond, Va.

Regarding the May 15 cover story "Patient. Consumer. Customer. Guest." (p. 16), you left out the part about the premium services many hospitals offer today. They realize the value in providing such services to those willing to pay for them and have dedicated floors or units providing them. Single rooms where quads are typical, suites for family members, etc.

The challenge for all (patients and facilities) is when the hospitals lose sight of patient care for those who are not able or willing to pay more. People should have the choice for a premier level of service. But facilities shouldn't be leaving common care at the admitting room door for everyone else.

Harvey Brofman

Holbrook, N.Y.

Regarding "Industry admits lack of transparency spikes drug prices" (ModernHealthcare.com, May 17), why not mention the three most pernicious causes of failure to allow market forces to work: the exceptionally long exclusivity a patented drug enjoys even if it was developed with taxpayer money; the inability of Medicare to negotiate pricing with drug companies (to me it would be reasonable to reduce the length of a patent if the drug sells for more in the U.S. than it does outside the country); and, lastly, pharmacy benefit managers and their ridiculous tiered treatment requirements that rupture the doctor/patient relationship, as well as their interminable appeals processes.

When will Congress stop coddling Big Pharma, insurance companies and other campaign donors?

Dr. Matthew L. Carr

Fort Lauderdale, Fla.

Regarding the recent Guest Commentary "Dr. Gary Kaplan on a 'systems approach' to fix healthcare" (ModernHealthcare.com, April 15), I couldn't agree more that fixing healthcare requires a systems orientation, but the fix must begin with a medical equivalent of the National Transportation Safety Board.

The Joint Commission works to improve care, but it doesn't deploy rapidly enough to a hospital where an unexpected death occurred to build the case for where the process or human error occurred. We need an entity to publicly share the details of mistakes and build upon lessons learned, focusing on the exactness of processes. It also should require physicians and nurses to spend time in simulators for the OR, inpatient unit and other departments in the same way pilots are trained.

Keith W. Gallagher

CEO, Wake Spine & Pain Specialists

Raleigh, N.C.