Your voice: Americans require a moderate solution to the healthcare crisis

Medical Economics Journal, October 25, 2018 edition , Volume 95, Issue 20

Letters from our readers 

Americans require a moderate solution to the healthcare crisis

I read with interest the “Your Voice” contribution by Dr. Craig Wax, “To solve the U.S. healthcare crisis, think small, not big.” My fundamental objection to Dr. Wax’s well-articulated position is that he represents an extreme position on healthcare in the United State, and Americans are (present political discourse notwithstanding) not generally an extreme people. Not recognized by Dr. Wax is the existence of the Emergency Medical Treatment and Active Labor Act (EMTALA) of 1986. This statute, passed in keeping with the compassionate nature of the American people, requires hospitals that accept payments from Medicare (i.e. nearly all) to provide at least stabilizing treatment to any patient seeking care on an emergency basis.  Because of EMTALA, some Americans rely on emergency departments for catastrophic care and eschew expensive health insurance altogether. The latter is not in the patients’, the hospitals’, or society’s best interest. 

The right position for the country is, per usual, a middle course that will provide the compassionate safety net, encourage individual responsibility for health and its cost, and assure a sustainable future for the providers of care. Healthcare legislation passed since 1986 has attempted to walk that line. Extreme positions on both ends of the spectrum need to be considered, but compromise and moderation must win the day. 

James P. Nataro, MD, PhD, MBA
Charlottesville, Va.

We must challenge the current healthcare dogma

It is refreshing to read an article that challenges the current dogma of our healthcare system. Promoting individual choice and advocating for diminishing the bureaucracy of our current healthcare system is an effort that is long overdue.

I applaud the perspective of Dr. Craig Wax, as well as your decision to publish his thoughts. This side of medical economics has not been adequately discussed.

Craig Hjemdahl-Monsen, MD
Hawthorne, N.Y.