Confronting insurers who won't pay; The FTC's stacked the deck against us; Don't blame doctors for a tort reform system gone wild
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Many thanks for helping us fight back against insurance denials ["When an insurer won't pay" and "Helping patients appeal insurance denials," May 9]. I implore you to publish more of these "real-world" powerful reports and "Clip and Copy" tools that help us get the job done. The time has come to stop mis-managed care from getting away with (literal) murder and economic robbery.
Gary Melvin Gorlick, MD
Editor's note: You'll find a new "Clip and Copy" medical practice form in each issue, and you can download any form in the series from the ME Extras section of www.memag.com.
It was clear in "FTC to doctors: Price fixing won't fly," [May 9] that the Federal Trade Commission's priorities are amiss. As a result of their policies, the playing field for doctors and insurance companies is nowhere near level. Large, national carriers with billions of dollars in assets have free reign to reduce prices mercilessly. When they dictate prices in a community, we see hospital closings, nursing shortages, and reduced physician access.
To oppose them as an individual doctor is economic suicide. However, a well-organized group of physicians would have the power to command appropriate payments for their services. I suspect many people fear that organized doctors might withhold care to gain economic advantage.
However, I cannot think of one example where a large group of doctors has organized to the detriment of the community it served. The same, alas, cannot be said for government agencies.
I am tired of being trashed and bashed by sophists like former claims manager David Karp who pontificate from their cozy ivory towers while collecting fat paychecks generated by me ["The way I see it: Tort reform isn't enough, " May 9].
By emphasizing medical errors and faulty delivery systems, Karp casts doctors as the culprits in the ongoing saga of blame over our broken medical liability system.
Yes, there are doctors who misdiagnose and misprescribe. But there will be little real tort reform until Mr. Karp and his colleagues acknowledge that the disease infecting our current system is the "frivolous claims" virus and that "loser pays" is the viricide.
Karp's abrasive lecture is not about tort reform. It's about maintaining the status quo so trial lawyers and insurance companies can remain the moneychangers in the temples of justice.
Calvin Ennis, MD
Corrections: In our June 6 article about a class-action lawsuit against 10 HMOs, a punctuation error made it appear that Aetna was part of UnitedHealth Group. Aetna is an independent company.
A photo caption in "Hire a pharmacist?" [June 20] misidentified the person conferring with FP Donald Moore. She is Michelle Bozovich, PharmD.
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Aug. 22, 2003;80:9.