Robert J. Samuelson was correct in his April 30 op-ed, “A real solution on health care,” that the most important way to reduce the cost of health care in this country is to control prices. Neither the markets for health insurance nor the markets for health care are competitive (the Affordable Care Act notwithstanding). And he avoided one common error: Does anyone really believe that if Medicare reimbursement went up, hospital and physician fees would go down? However, he casually made another error, unfortunately also common: that if the price of insurance to employers goes down, employers would pass the savings along to workers in their wages. I don’t think so.
In the 1980s, many large companies switched from defined-benefit pension plans — which paid workers a fixed monthly sum, for life, based on years of service and wage level — to defined-contribution plans, which allowed workers to save money for retirement in a tax-free investment account, to which the employer might or might not contribute. Defined-contribution plans were much cheaper for employers (and much riskier for employees), but I am not aware of any evidence that the money employers saved went into their workers’ wages. These days, many corporations pay rank-and-file workers as little as they can get away with.
Caroline Poplin, Bethesda
Once again, doctors and hospitals are called the bad guys in the discussion regarding the rising cost of health care. Robert J. Samuelson clearly missed the real villains here: the health insurance companies.
I speak for the doctors, who have few allies in the fight for fairness regarding compensation for the care we provide. It is a myth that we may charge “higher prices” to the private insurance carriers. They pay an “allowable” fee for any visit or procedure, the amount of which decreases virtually every year. Or, they pay nothing if they can find a way to “deny” a payment. Many doctors are struggling to pay their escalating overhead, while receiving whatever crumbs the insurance companies choose to throw at them.
Meanwhile, the insurance companies are exacting higher premiums and higher deductibles from consumers. At the same time, their executives are making ridiculous incomes and bonuses.
Control or eliminate the insurance industry, and you will rein in the cost of health care. Doctors are doing the very best we can for you, and we are not getting rich doing it.
Eric J. Furst, Springfield