Price of basic tests explains medical crisis | June 2
Defensive medicine drives up cost
This timely article brings to light what is undoubtedly a critical contributor to our health care crisis. I believe it is important to elaborate on certain points, if only for clarification purposes.
It is true that physicians many times order tests that may not necessarily be imperative to diagnose or treat a patient. The tests keep being ordered not because of any financial incentive to the physician (in the overwhelming majority of the cases there is none), but because of the unfortunate need to practice defensive medicine in this terrible, litigious environment. Until we approach tort reform in a realistic and responsible way, this is not going to change.
The article also states that "hospitals, drug companies, device makers, physicians and other providers" can benefit from charging inflated prices. I can only speak from the physician's point of view. Typically most physicians will be paid a fraction of Medicare-allowed fees (less than 80 percent to just over 100 percent) for any services they provide. I do not know many doctors who are able to charge outrageous fees for services to insured individuals, since they have contracts with insurance companies that will keep reimbursement fees under the 100 percent Medicare rate allowed.
In my experience, patients with no insurance are treated at an even reduced fee (if we charge them at all). The Medicare-allowed fees have not increased substantially over the years (although our office expenses certainly have), and we are always under the threat of substantial cuts in Medicare reimbursements on a yearly basis.
The real problem lies in the multimillion-dollar corporations (including both for-profit and nonprofit hospitals) that have lobbying influence to allow for the status quo to remain, where institutions are indeed allowed to charge obscenely profitable fees for their services. (Just visit reception areas of the most recently built hospitals to see where the money is going: They look like five-star hotels.)
Not only do they receive very high payments from the privately insured population, but disgracefully they charge outrageous fees for those individuals without insurance who are not poor enough to qualify for Medicaid. This is truly a very sad picture.
Jesus L. Penabad, M.D., Tarpon Springs
Criticism hits transportation panel | June 2
Panel serves the public well
Tampa Mayor Bob Buckhorn should spend more time worrying about the city and less time concerning himself about a special-purpose unit of government like the Public Transportation Commission that has served the people of Hillsborough County very well for many years.
The PTC, like its counterparts in other major cities in the United States — especially in high tourism areas — exists to protect the traveling public.
It never ceases to amaze me every time there is a special event in the city or county, various characters from other states try to find ways to get a piece of the action through one scheme or another. Such was the case with Uber, the private driving service from San Francisco. Uber wanted the PTC to change its rules so it could make money at the Republican National Convention. I applaud the PTC for sending Uber back to California.
PTC chairman Victor Crist was correct in his statements to your reporter who covered the Emerge Tampa Bay session. Wherever you travel in the nation, limousines or sedans have a minimum change to allow a balancing of the equities between limousines and taxicabs.
Eliminate the PTC and Hillsborough County will have criminals driving vehicles for hire, which the PTC eliminates by virtue of its enforcement of the law and its rules.
Paul J. Marino, Largo
Many small insurers fail | June 3
I've just opened Greg's Insurance, a start-up property insurance company in St. Pete Beach. I would like to learn how I, too, can "takeout" 60,000 Citizens policies for the discount price of $52 million.
Now, mind you, I did not give Rick Scott $110,000 yet; nor did I invest another $30,000 with the Republican Party of Florida. I did, however, decide to make this magnanimous offer at the very beginning of hurricane season. I figured that would give me a month or so to "select" which of these policies my new company would have the least risk of actually paying out a claim to. And, if the Big One does hit, will at least give me enough time to run to the Caymans to safely stash my share of the proceeds.
I do promise that Greg's Insurance is not just another Homewise (who got $116 million) or Atlantic Preferred (who got $236 million). Mine is a legitimate company with thousands in assets who only wants to help Citizens out of the jam they find themselves in ($6.4 billion in surpluses).
Gregory Premer, St. Pete Beach
How to get rich in four easy steps:
1. Start an insurance company.
2. Get millions of dollars by taking over policies from Citizens Property Insurance Corp.
3. Take all the money out of the company and declare bankruptcy.
4. Relax and enjoy the good life, or start at No. 1 and repeat.
Emiliano Quindiagan, St. Petersburg
Taxpayers left holding bill
Here's the dirty little secret that isn't talked about. When Citizens Property Insurance Corp. sells off these policies to politically connected, underfunded brand new insurance companies that fail, all of the rest of us — the taxpayers — pick up the bill and make sure the insured is covered. We created the Florida Insurance Guaranty Association, which provides a safety net so when your insurance company goes belly up, you won't go belly up too (even though you paid your premiums).
So, other than the brief experiment with privatization and all of those nice salaries, bonuses, etc., paid to all of the executives of these newly formed, undercapitalized companies before insolvency comes knocking, exactly what is the point of Citizens temporarily offloading these policies? In the end, we are still on the hook as taxpayers.
Here's a thought for Citizens. Instead of giving away millions in subsidies to those who write political contribution checks, how about taking that money and moving it from your right pocket to your left pocket and just keep the policies — we'd be ahead. Or, even better, require the new companies to be bona fide and have real reserves and paying power. Some start-ups don't even have claims departments. What does that tell you about their business model?
Gary Gibbons, Tampa