Letters to the Editor - May 18, 2009

Is goal more quality or less payment?

Regarding "Obama budget sets stage for reform of health care system, Medicare pay" (Article, March 9): President Obama may be well-meaning with his plans. At first glance, however, it appears that this administration wishes to develop a system fraught with even more bureaucratic snags and traps sold as methods to "increase quality" but whose true purpose is to decrease physician and hospital payment.

The layers of bureaucratic complexity now being created under the guise of quality are mounting. Ultimately, these changes will trigger unintended consequences, and I believe that we will eventually learn that patients were harmed as a result.

Also, if primary care physicians are not paid adequately for their services, this should be changed, but specialist colleagues should not be thrown to the proverbial wolves in order to meet the needs of primary care.

The idea that the governmental spending restrictions and red tape will actually improve quality of care is preposterous. We have enough organizations like state medical boards, the Joint Commission and so on with the sole purpose of looking out for the safety of patients. Moreover, the constant liability that hangs over every physician and hospital is another great incentive to practice "best care." The AMA must not endorse programs that claim to improve quality by reshuffling the deck in favor of those who jump through bureaucratic hoops.

As concerned agents for our patients' welfare, we should be unified in our demands for fairness and efficiency, and we must reject bureaucratic solutions that can only decrease quality, decrease access and increase cost.

--Paul K. Holden, MD, Tustin, Calif.

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