Letters: Under what authority can arbitration be imposed on doctors?

The May 16 article “Senators introduce surprise medical bill ban with arbitration” says, “A bipartisan Senate coalition made its long-awaited pitch to end surprise medical bills, with arbitration as a final resort if providers and insurers aren’t happy with proposed pay rates.”

It seems peculiar that the government thinks it is acceptable to indirectly set physician fees. I would ask by what acceptable logic a physician must accept a reimbursement rate from an insurance company with whom he or she has no relationship and no contract. Under what authority can this be done?

If it can be done to physicians then certainly it can be done to other individuals participating in what was once a free market. Certainly, lawyers, CEOs and others ought to have their pay set under the same arguments used to defend this intrusion into a physician’s market freedom.

It seems that the true underlying motivation here is to buy votes at the expense of sacrificing what little remains of market freedom for doctors.
 

Dr. Allan Dobzyniak
Eastport, Mich.

Regarding the May 16 editorial (“People die while the FDA dithers on generic insulin”), reading such articles saddens and angers me. It’s time to more forcefully confront these drug companies. Their behavior is the best example of why private market dynamics should be excised from healthcare. Such a market breakdown—and that is what this is when viewed from a consumer perspective (and that should be the ruling perspective)—requires a countervailing governmental force to make a market correction.

How best to do that? Directly override the patents that allow these companies to string out their monopolies. Of course, their heads will explode, but that is better than the ongoing financial bleed out that consumers now experience. Another governmental alternative: Create a “public option” by licensing a willing company to produce a generic basic insulin—yes, a version of the one that worked so well, so cheaply, for so long—and put it into the marketplace at a reasonable price.

It’s really past time to continue working at the margins here. In the face of what can only be called systematic and ongoing price-gouging, we need a more confrontational and effective approach to break this cycle.  

Naturally, such a commonsense approach will never get through Congress, as currently apportioned. Organizations and citizens must team up to fight for needed change.

Les DelPizzo
Baltimore 

Regarding the May 4 Guest Expert column by the Medical Group Management Association’s Dr. Halee Fischer-Wright (“Look before you leap—what primary-care doctors should know if private equity comes calling”), I have been helping small independent practices stay independent for over 20 years. I had not lost one to a hospital system or private equity until this year.

If you are a dermatology practice with five-plus doctors, there is a pretty good chance you have been contacted by a private equity group. We finally have a client who is making the jump. It’s too early to report any positives or negatives, but it is to be expected with that specialty. But still no primary-care doctors.

Independent small practices can still do very well and thrive in this changing landscape. Also, we are hearing that the acquisitions by hospitals have plateaued. Maybe private equity presents another option for the doctors, but the hospitals have not had great success with the physician clinics. Success being defined by losses and gains, I’m not sure about the clinical outcomes.

Jeff Robertson
President and CEO
Nexsys Billing and Practice Management
Torrance, Calif.