History teaches that in many industries, the first people with enough courage to speak up about dangerous practices are often fired. Bravo to ob/gyn David Gearhart, internist Farrin Manian, and RN surgical assistant Carol Hollowood for having the guts to challenge health care organizations willing to risk lives to save dollars ["Can you speak your mind and keep your job?" April 23]. They are now on my personal list of health care heroes.
Martin J. Hatlie
President, Partnership for Patient Safety
I read with interest the April 23 Memo From the Editor regarding the roundtable discussion on the state of our nation's health care. While I respect the members of that select panel, I don't think it should have dismissed a universal national health plan as passe.
I, along with nearly 10,000 other disgruntled physicians, belong to Physicians for a National Health Program (www.pnhp.org ). We readily acknowledge that the US health care system is seriously flawed. Despite the fact that this country spends far more on health care than any other industrialized nation, over 42 million Americans have no health care coverage.
I agree that Hillary Clinton's plan was flawed, but we've got to do something other than apply more Band-Aids to remedy our current mess. While Congress has already passed a gigantic tax cut, and is considering a multitrillion-dollar defense shield, we still have not acted to ensure that every citizen has adequate access to health care.
Howie Wolf, MDLafayette, COLobo985@home.com
Editor's Note: For the roundtable discussion itself, see "What it will take to fix the system."
Re: the April 9 Practice Beat item about Cigna HealthCare of Georgia's agreement to pay a $300,000 fine for violating the state's prompt-payment law.
In the latest twist on delayingor even denyingpayment, a growing number of insurance companies have been sending questionnaires to the insured asking for additional information. One questionnaire that I have seen contained eight questionsand nowhere did it indicate that failure to respond promptly would result in delay of payment.
Some companies further complicate matters by requiring that replies be phoned in by the insured. One of my patients, a plumber, has a two-hour commute to work. I can just imagine him on a cell phone trying to wade his way through a 20- or 30-minute maze of computerized questions before speaking to a person.
Edward B. Feehan, MDMerced, CA
ER physician David Klocke's account of his ordeal with a drug-addicted colleague ["Why is it so hard to report a problem doctor?" April 9] was all too typical.
I mentored a couple of my colleagues who had substance abuse problems, and was favorably impressed with the way each situation was resolved. If you have good reason to believe that another physician is abusing drugs or alcohol, notify the area's drug enforcement people. They, in turn, will do their own checking and "discover" the problem, without your name being mentioned.
Louis S. Moore, MDNaples, FL Louis@MooreStudios.com
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Gail Weiss. Letters to the Editors. Medical Economics 2001;12:14.