Mr. John F. Cogan
Mr. R. Glenn Hubbard
Mr. Daniel Kessler
Editorial and Corporate Headquarters of the Wall Street Journal
1211 Avenue of the Americas
New York, NY 10036
I read your article in the WSJ from Friday March 11th about Obamacare and “cost shifting”. I greatly appreciate your getting out the message that “cost shifting really does not occur”. But, you left out one VERY important point. The doctors are the ones who are carrying the brunt of the cost of the uninsured.
As a member of a major hospital medical staff, I am REQUIRED to see anyone who comes to the emergency room for a urology problem on the day that I am “on call”. I cannot turn anyone away because they cannot pay. Ours is not a charity hospital, but the uninsured know that we do a good job and they come in droves.
Last year, alone, I did over $120,000 in free work. Most of this work was for illegal aliens without any insurance. I will never receive a penny of money for this work and I cannot write it off my taxes. Furthermore, I am held legally responsible should a personal injury lawyer claim the result was less than perfect. This represents mostly surgery that is done on weekends and after hours. This work is a major burden on my family life. To my knowledge, every xray that was done on every one of these patients was done for free by the radiologist on call. To my knowledge, every anesthetic given to every patient was done for free.
I have been a urologist since 1986 and I have never been paid a penny by any government or charitable agency for the work that I have done while on call for the uninsured! Over these many years, I suspect that I have done over 3 million dollars in work for which I will NEVER be compensated in any way! There are about 40 urologists at my hospital, so you can do the numbers and see that we are providing a vast amount of work for "free".
I have NO ability to pass this loss on to anyone! I have contracts with insurance companies and they pay a certain amount for care and there is NO way to get them to increase that amount. Most companies pay about what Medicare pays. I cannot balance bill any Medicare patient and so I get what Medicare chooses to pay for services and have zero ability to influence that dollar amount.
So, the idea that a doctor can “cost shift” is nearly comedic. I wish that the WSJ would speak more with physicians to get a clearer picture of what is really happening. The organization Docs4PatientCare always has members that would be willing to speak to you. Please visit their website to learn what "practicing" physicians are doing to promote practical and affordable medical insurance reforms that preserve the sanctity of the physician/patient relationship while minimizing government control over Americans' personal health decisions. www.docs4patientcare.org.
Dr. Martha B. Boone