Letters to the Editor

Insurance industry impedes reform efforts

As a rural family physician since 1988, I have seen private insurance companies creating more hassle for me and my patients while increasing co-pays and premiums annually - without increasing physician pay.

The outsourcing of Medicare to private insurers via Medicare Advantage plans has proven to be 13 percent more expensive to the federal government, according to the Congressional Budget Office. Medicare Advantage plans should be eliminated if Congress is trying to save health care dollars and provide care to more people.

Why should public tax dollars for Medicare or Medicaid have to be filtered through an insurance company and thereby create more hassle for my patients on these two important health care safety-net programs and more headaches for me - just to give an insurance CEO a multimillion-dollar salary?

I agree with President Obama that there are enough cost savings within our Medicare and Medicaid programs to fund the expansion of medical care to the uninsured. However, it appears that instead of focusing on that idea, Congress wants to protect the insurance industry from competition or, worse yet, outsource our health care tax dollars to the private insurance industry. After my experience as a gubernatorial candidate in the 2006, I believe this is largely happening because of contributions made to our political leadership from insurance companies.

As part of his plan to outsource Medicaid insurance to the private HMO market, Gov. Mark Sanford terminated the public Medicaid program component - which was designed by S.C. physicians over a three-year period under Gov. Carroll Campbell's administration, and which was saving tax dollars and successfully providing a true primary care medical home for Medicaid patients. Patients enrolled in this Physician's Enhanced Program used the emergency room less and received more preventive medical care.

Dr. Bill Pittard at MUSC demonstrated significant cost-savings from this program to our state budget in the Journal of the South Carolina Medical Association in October 2007. The Physician's Enhanced Program saved an average of $2,763 per Medicaid child over the first two years of life when compared to Medicaid HMO programs. Medicaid covers approximately half of all children in South Carolina.

Even after Dr. Pittard and I met with Gov. Sanford to be sure he understood this and gave him the clear documentation supporting the peer-reviewed article, our governor still terminated the program, which had been operating well for eight years.