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Your Voice: Physicians must be on same page to truly contain healthcare costs


Containing healthcare costs and MOC are the hot topics of this edition of Your Voice.

In response to “Disappointed in Gruber comments on Obamacare (Your Voice, July 25, 2016),” Dr. Badolato seems upset with the idea that “healthy people are going to pay in and sick people are going to get subsidies.” 

Isn’t that the way that health insurance, or any insurance, always works? The premiums of all pay for the claims of some, and the actuaries set the rates. 

We currently have a maze of insurance products from corporations that subtract their profit from every healthcare dollar we spend.  That can eventually be replaced by a uniform, low administrative cost (currently 2%) universal health care system, like Medicare. Obamacare is just a baby step along that path.

We already have healthcare rationing, but right now the rationing rules are set up by unelected, unaccountable corporations. When I can have a list of medications and procedures that are covered and the requirements for using them or for getting alternatives, I’ll just learn that, and my life will be easier and I’ll get back the 15% of my time that I spend navigating the hundreds of insurance plans and changing networks that my patients have to use.

As a nation, we need to contain healthcare costs. Finding ways to do that will be easier when we can all be literally on the same page, looking at a uniform health insurance rule book and having input to improve it-slowly no doubt, but rationally, motivated by the needs of patients, not stockholders.


Ellie H. Bloomfield, MD

Glendale, California


ABIM needs to prove MOC is useful

In the article “The man behind MOC defends the program against critics (Medical Economics, August 10, 2016),” you asked the question, “Is there any evidence that certification, or lack of certification matters to patients?” but that is an irrelevant question. 

Patients don’t know whether MOC has any value and the sad fact is that Dr. Baron doesn’t know or care about the answer to that question either. 

The only valid question is whether MOC actually makes us better physicians and results in better patient care, but to date, the ABIM has provided no evidence to answer this important question. 

Physicians are expected to practice evidence-based medicine. The ABIM would be more honest and respected if their practices were equally evidence based especially given the enormous investment in time and effort required by our nations physicians to comply with this process. 

If they can’t prove that MOC makes a difference, then MOC should be ended. If they won’t provide evidence that it’s useful, then they are unworthy of respect from physicians or institutions.


Michael Melgar, MD

Great Neck, New York


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