Peter R. Orszag and Ezekiel J. Emanuel ("The truth about out-of-pocket medical costs," Jan. 8) grow ecstatic over the touted benefits of Obamacare high-deductible insurance and increased insurance coverage.
Political malpractice by the likes of Emanuel and Orszag has led us to unaffordable deductibles packaged with unaffordable insurance controlled by merged HMO-ACO corporations. After some irrational economic mumbo-jumbo, they say, "people tend to deal with deductibles irrationally."
Their new Obamacare cost-control twist is corporations profit-driven to ration care at the nation's bedside. Corporate gatekeepers are paid more for ordering less care and paid less for ordering "too much" use of corporate money.
Can we fix this high-priced, apparatchik-controlled medical marketplace? It's not likely to work if the government pays for all care and rationing is still controlled by profit-driven merged medical delivery insurance corporations.
A prescription that could work is a medical marketplace in which the consumer is king, and where money is controlled by millions of families, not a few self-interested corporate or political apparatchiks. When buying insurance, goods and services, millions of American families with money from wages, savings or a safety-net public program are wiser than a few apparatchiks. That's true in every other microeconomic sector; why not medicine?
Dr. Robert W. Geist, North Oaks
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The Jan. 4 article on the disparity of surgery costs ("Surgery costs get rare reveal") highlighted a topic that Time magazine addressed in 2013. At that time, the magazine — for the first (and only) time in its history — featured one topic only by one reporter only. That man's name is Steven Brill, and he wrote a comprehensive story about how costs are assigned by each medical institution using something called the "chargemaster" to determine what should be charged. The article was called "Bitter pill: Why medical bills are killing us" (tinyurl.com/Brill-medical-bills), and it's a shockingly eye-opening story about why some are charged very little while others pay much more and how those costs are decided. The bottom line is that our medical care needs an overhaul or, as Brill more succinctly said it: "Put simply, the bills tell us that this is not about interfering in a free market. It's about facing the reality that our largest consumer product by far — one-fifth of our economy — does not operate in a free market."
Janet Stahlberg Hammer, Minneapolis
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