Regarding the Center for Public Integrity’s Dec. 23 story, “Hospitals feel political pressure as facility fees pile up”:

America’s hospitals are available 24 hours a day, seven days a week and 365 days a year to provide for the health-care needs of their communities. But the standby role in providing these essential public services is not explicitly funded by Medicare, Medicaid or private insurance, and hospitals face increasing challenges in maintaining this role. These “standby capacity” costs — such as around-the-clock availability of emergency services; emergency back-up for other settings of care; disaster preparedness; a wide range of staff and equipment — make hospital-level care more expensive, and these costs are spread across all hospital services, including outpatient services.

Other care providers don’t share these roles or bear these costs and are not held to such stringent regulatory standards, which is why hospitals need higher reimbursement. And more physicians are joining hospitals as they are finding it harder to make ends meet with what Medicare pays them.

The care provided by hospitals is an essential component of our nation’s health and public safety infrastructure. Cutting payment for hospital outpatient care could threaten vital patient care.

Rich Umbdenstock, Washington

The writer is president and chief executive of the American Hospital Association.