Reader Comments

Editor: Good column, “No Medical Charity Allowed,” on a subject people need to know about. Philip Gold

Editor: Great editorial on “No Medical Charity Allowed.” It gave me a lot of insight on the cost of a doctor’s appointment. Dick Haynes, Piqua, OH

Editor: The practice of dragging doctors off to prison for being charitable as detailed in your “No Medical Charity Allowed” is simply terrible. It is just another case of government out of control. The people in the governmental programs do not want to lose any control as it is POWER but as the article has shown it kills any incentive to forgive medical bills. Governor Sanford is right in his approach to remedy this miscarriage. Sumner Thompson

Editor: You report that the nonpartisan Center for Studying Health System Change was "at a loss explaining the decline" in the proportion of U.S. physicians providing charity care — down from 76 percent of all physicians in 1996-97 to 68 percent in 2004-05. This simply is not the case. The study clearly states that a number of factors — ranging from declining real physician incomes to stagnant public and private reimbursement rates to changes in how physicians organize their practices — are all likely drivers of the decline in charity care. You also state, "The only reason the study shows so much charitable activity is that the physicians counted extra time spent at hospitals treating indigents as charity, which it really is not since treatment is required by law." Again, this is simply not the case. One need only look at the actual study to find that more than 70 percent of the physicians who provide charity care do so in their own practices, while about 14 percent report providing charity care while on call at a hospital emergency department. Your inaccurate portrayal of our study provided a springboard to speculate that more physicians are opting not to provide charity care for fear of being hauled off to jail for violating Medicare and Medicaid rules. In the 10 years that we have studied physician charity care, neither physicians, policy-makers nor researchers have ever mentioned this issue as a reason why some physicians don't provide charity care. Surely you don’t think this is true, or he must believe that the 68 percent of physicians who continue to provide charity care are scofflaws. In any event, these policies have not changed in the past 10 years, so it is extremely unlikely that they could be contributing to the decline. ALWYN CASSIL, Director of public affairs, Center for Studying Health System Change, Washington

[Editor responds: Imagine that doctors do not tell his interviewers that they are evading the government! If this is imaginary, how does the Center explain my correspondent’s job being paid to stop physicians from giving undocumented charity? Of course, I mentioned the Center had other explanations but said they could not explain the change since they were perennial problems whereas the government has only been hard-balling payment rates and audits over the last decade. Fortunately, there are many good physicians granting charity in spite of the efforts of the Federal Government to dissuade them.]

Editor: Thank you for your editorial on doctors' costs and payments received. It does seem a bit odd that you haven't complained about the $500 to $3,000 doctors' fees for ten to fifteen minutes of marginally professional work. Maybe their union is too powerful. Sincerely, Wilbur W. Wiley

Editor: Please do all you can to reform the catastrophic mess mentioned in your editorial “No Medical Charity Allowed” that the government has created in its misguided efforts to help people while cutting the cost! It is causing people to suffer whether they use the services or not! Frances Shannon

Editor: In addition to the problems detailed in “No Medical Charity Allowed”, I've experienced another one. More and more physicians are refusing to accept Medicare or Medicaid, for all of the reasons stated in the article and more. I personally refuse to even try to use my Medicare, because so many procedures and treatment protocols are not covered, and if a doctor takes Medicare, he/she may not offer these types of procedures and treatments. I have chosen the "natural as far as humanly possible" route to continuing health, and most of the tests and "prescriptions" are not covered under Medicare. So I go to a doctor who practices this type of medicine, and does not accept any insurance whatsoever. Nor does she buy malpractice coverage, so all patients must sign a waiver in the case of any complaint - there is "arbitration" offered to settle any claim. Now - I'm not wealthy, just "comfortable", so I have to limit my visits and my procedures, so that I'm able to pay for them myself. It's not easy, and the natural products I use to prevent or treat whatever ails me are, of course, not covered either, so I pay for those too. So far, so good - I'm 76. Governor Mark Sanford has a good idea - but the do-gooders who want to control the whole thing as they do today won't let it succeed on a national scale. They won't even let the matter be thoroughly examined or debated. Furthermore, our hospitals are in danger from the limitations of the system and the overload in their emergency rooms, which are what the indigent and the illegal immigrants use for their primary care. Jean L. Martin (M.A., M.S.S.W., retired), Richardson, Texas

Editor: Regarding “Watch Your Wallet” by Nathan Tabor--silly question. I wonder if my husband and I both paid our $30K each to the government right now - could we be excused from federal taxes the rest of our lives? Ha-ha. Paulette Carey

Editor: It is nice to see in Nathan Tabor’s “Watch Your Wallet” someone who is right on target. Too bad we have congressional representatives that just don't get it. I just came from a site that listed how all the taxes will be spent in Florida this year. Seems like everyone depends on the Federal Government to be the answer to all their problems. I will send his column to all my representatives, state and federal and the senators also. Thanks for a great article. Dennis M. Purvis, Orlando, FL

Editor: Good column by Timothy Carney. Ethanol should be in the farm program not an energy consideration. The current ethanol program is what I call FLEECING OF AMERICA. Ken Johnson, Tremont, Illinois

Editor: Regarding Steve Lillienthal’s article “National Identifier,” I don't want my Social Security number to be used for anything but its original purpose. It should not be used for credit identification or anything else. Charles

Editor: Regarding Tom Pauken’s piece on John McCain, I am a conservative and will NOT vote McCain. He's tied to the hip of Teddy Kennedy. Annette Burke, New Alexandria, PA

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