Letters to the Editor - March 7, 2005

ISMS: AMNews should have known key source aligned with trial lawyers - Why full price for cash payers but then a break for managed care? - Drug company assistance programs can come with too many hassles

ISMS: AMNews should have known key source aligned with trial lawyers

Regarding "Preventing lawsuits: Coalition pushes apologies and cash up-front" (Article, Feb. 7):

Those of us in the Illinois State Medical Society are nonplussed at how completely it appears that the wool was pulled over the eyes of a national, objective news outlet such as AMNews.

A central source for the story, Mr. Doug Wojcieszak, actually heads up Victims and Families United, an organization that news reports have widely identified as being backed by plaintiff attorney interests. The group is located in the Metro East St. Louis area of Illinois (notorious as a national "judicial hellhole"). Any credibility that affords him to forge a "middle-ground solution" to the litigation crisis, as he states in your story, completely escapes us.

In fact, the Illinois "I'm Sorry" proposal cited in the piece is part of a comprehensive ISMS reform package that the plaintiffs' bar vehemently opposed last year.

Suffice it to say that at the ISMS, "We're sorry" AMNews didn't get the straight story on this issue.

--Kenneth J. Printen, MD, president, Illinois State Medical Society

Why full price for cash payers but then a break for managed care?

Regarding "Health savings accounts make impressive strides" (Article, Jan. 31) and "With HSAs, expect calls to cut fees" (Letters, Jan. 31):

The recent article on health savings accounts, as well as the letter by Olgard Dabbert, MD, San Diego, was interesting. Frankly, I am tired of reading articles in AMNews about the draconian practices of managed care while the acts of physicians toward cash-pay patients, which are equally egregious, seem to get no press coverage whatsoever. I am a cash-pay patient because I have chosen a high-deductible insurance plan designed to cover catastrophic needs only.

In the last two years, I have yet to encounter a physician office that gives a discount to the cash-pay patient. I am charged full price. I am unable to understand why physicians will give a deep discount to a managed care corporation, with which they have to do battle and wait months to get paid, but give no break to the person standing there with a credit card in hand, whose money they will collect almost immediately.

Do physicians not realize that the road back to control of medicine runs straight through the encouragement of cash-paying patients? The cash-pay patient should be getting the best price, not the highest. I would appreciate a response from some physicians who can provide me with a principled and rational explanation for this practice. This current practice just encourages me to join a managed care organization, which seems to be just the opposite of what physicians should be promoting.

--Michael R. Cavenee, MD, Plano, Texas

Drug company assistance programs can come with too many hassles

Regarding "Iowa practice draws notice for its 'no-gift' policy" (Article, Feb. 14): I share the conviction of the physicians quoted in your article that the intensive marketing programs of the drug manufacturers waste physician time and misuse financial resources that might better be applied to reducing drug costs to patients. However, I do not feel that the drug company assistance programs as they currently exist are a viable solution for patients who cannot afford medications that are more expensive here than in numerous other countries.

Recently, my nurse and I spent in excess of three hours completing paperwork and juggling medications so that one patient could receive some semblance of the same eight medications that she was already taking. Each company has a different form to complete, and not all programs will admit new patients (we had to change several medications for that reason). It appears to me that the process was designed to discourage doctors from participating, thus limiting the drug companies' cost for assistance.

Perhaps the Pharmaceutical Research and Manufacturers of America needs to encourage its members to develop a cooperative program and a single, simple form for physicians to complete. I also think that the manufacturers need to divert just a small fraction of the financial and human resources that they spend for marketing to running such a program.

--Alan Weamer, MD, Davison, Mich.