Opinion | Maximizing Profits at the Patients’ Expense

To the Editor:

Re “Patients Hit With Big Bills While Insurers Reap Fees” (front page, April 7):

Chris Hamby’s investigation uncovers the hard truth for patients who receive care from providers outside their insurance network. While most of us try to save out-of-pocket costs by using in-network health professionals and hospitals, it’s not always possible. And there’s no way to determine what we’ll owe until after we get that care — when it’s too late to reconsider based on the costs we’ve incurred.

So, it’s more important than ever for the government to swiftly implement an essential element of the No Surprises Act: Providers should have to give patients an advance explanation of benefits so patients can estimate their financial burden before they get treatment, in or out of network.

Health price transparency is improving, but it’s outrageous that even two years after the No Surprises Act passed, everyone except the patient knows the price of a procedure or doctor’s visit in advance, leaving patients unpleasantly surprised.

Patricia Kelmar
Alexandria, Va.
The writer is senior director of Health Care Campaigns for U.S. PIRG.

To the Editor:

This is just the latest example of the schemes deployed by insurers to maximize profits by cutting reimbursements to physicians and shifting medically necessary health care costs onto patients.

Whether it’s through third-party entities like MultiPlan or using tactics such as narrowing provider networks and restrictive prior authorization policies, insurers have the perverse incentive to boost revenue over offering adequate payment for quality patient care under the guise of “controlling costs.”

More and more patients are being forced to decide whether they should forgo treatment because their insurer won’t pay the bill.

Federal and state regulators must re-examine arrangements with consulting and analytics firms like MultiPlan, including their conflicts of interest and impact on patient care.

The College of American Pathologists has also encouraged lawmakers to enact tougher network adequacy standards that mandate that health plans maintain enough physicians under contract in the patient’s local area. Such requirements would give insurance companies the right incentives to cover patient services in the interest of keeping its beneficiaries healthy instead of producing healthier bonuses for its own administrators.

Donald Karcher
The writer is president of the College of American Pathologists.

To the Editor:

This infuriating article has many villains, especially MultiPlan and several huge insurers. The underlying issue, however, is the growing role of investor-owned, for-profit firms in the health care sector.

When I started studying health care as a doctoral student in the early ’70s, most hospitals were not-for-profit and most health insurers were Blue Cross/Blue Shield plans. There were problems then, too, but they pale in comparison with those of today.

Whenever profit enters the picture, that becomes the primary goal. And although the profit incentive is supposed to be good because it rewards better service and lower prices, and therefore stimulates innovation, it is possible to earn exorbitant profits through other means, as the article demonstrates.

Insurance is supposed to make care affordable for people so they can receive it without worrying about whether or not they can pay for it. Instead, the companies in the article focus not on making care affordable for patients, but on maximizing profits.

It may be wishful thinking, but somehow we need to find a way to get profit out of the health care sector again.

Stephen M. Davidson
The writer is professor emeritus at Boston University’s Health Sector Management Program.

To the Editor:

Re “Could Donald Trump Really Go to Prison?,” by Norman L. Eisen (Opinion guest essay, April 21):

After I read Mr. Eisen’s article, the possibility of Mr. Trump’s conviction and sentencing hit home.

I was a trial attorney for decades, and my appreciation for jurors has increased exponentially.

The jurors empaneled in this trial are showing bravery above and beyond. Many of the usual suspects have fanned the flames of hatred and potential violence by continuous attacks against certain participants in the trial. The jurors likely know this, and yet they agreed to sit in this case.

Each juror is a profile in courage. We owe them an enormous debt of gratitude. They must be protected. Democracy demands nothing less.

David S. Bright
Beverly Hills, Calif.

To the Editor:

Re “Black Voters’ Generation Gap Poses Problem for Biden Camp” (front page, April 19):

I’m deeply disappointed that this article suggests that some younger African Americans won’t vote because we don’t know our civil rights movement history, are uninformed about the issues or only have the same concerns as other voting blocs. Younger African Americans aren’t thrilled with the Democratic Party because it doesn’t give us specific policies.

Democrats court other groups of voters, and we want to be courted too. We need Democrats to fight fiercely for reparations for Black people descended from American chattel slavery, help close the racial wealth and homeownership gaps, provide significant federal funding for H.B.C.U.s and reinvest in our communities.

Don’t treat us like a captured voting bloc. Our parents and grandparents have personally experienced significant changes because of Democratic policies. Younger generations haven’t seen that same change.

Believe it or not, there are informed younger African American voters. We read Essence, Ebony, Blavity and other publications with significant younger Black readerships. Reach out to reputable Black journalists and academics. Try reaching us through those channels, not “The Breakfast Club,” the radio show.

Nichole Nelson

To the Editor:

Re “News Outlets Say Candidates Should Debate” (Media, April 15):

A group of major news organizations advocating a televised debate issued a joint statement that included this quote: “There is simply no substitute for the candidates debating with each other, and before the American people, their visions for the future of our nation.”

That assertion is patently hyperbole. It is better for ratings than it is for the electorate.

There are indeed superior methods. When professional organizations hold elections, their candidates prepare brief videos. They succinctly offer information about their backgrounds, why they are running and how they plan to address significant issues facing their constituents.

Additionally, candidates provide comprehensive written responses to a series of questions so voters can evaluate their proposals and have ample time to consider them. In the case of our upcoming presidential election, news outlets should devise a set of questions for each to address, which can then be viewed side by side.

While a televised debate could provide entertainment for the public, its emphasis on showmanship, and the usual ad hominem attacks, are hardly valid means to decide who would be best suited to govern. For virtuoso stage performances, there’s Broadway.

Lawrence Balter
New York
The writer is professor emeritus of applied psychology at New York University.