April 8, 2013

The April 5 editorial “Looking for leadership on Medicare” supported the concept that seniors must have “skin in the game” to facilitate cost control. Presumably, The Post means that patients should face some type of financial disincentive for choosing to access the medical system in situations not deemed cost-effective.

However, of all those involved in medical care (providers, payers, insurers, regulators, etc.), the patient is the least trained to decide whether to seek care and incur a financial burden or to forgo care and save money. The sicker the patient and the more urgent the need for a decision, the less likely that person is to make a well-informed decision of this kind. Finally, having “skin in the game” is much more likely to discourage the poor from both appropriate and inappropriate care than to affect the well-to-do.

Yes, Medicare must be made cost-efficient, but why put the onus on patients, who are the least able to protect their own “skin” from the consequences of the “game”? 

Allan R. Glass, Bethesda