Your editorial entitled “Another costly ACA symptom” rightly sheds light on the inability of the ACA to control the rise in health care costs.

However, I find your idea that Congress should explore proposals that would push consumers (patients) to consider costs before they make health care decisions to be impractical and often dangerous.

The march to raise deductibles, increase co-pays and severely restrict provider networks has been going on for more than a decade and has been accelerating. As every physician with even a little clinical experience knows, the ideal policy is to have no deductibles, co-pays or limits on appropriate providers for all basic/essential medical services. Then patients are much more likely to seek and maintain appropriate care.

Too often essential medication, treatments and physicians visits are skipped when they don’t fit into the family budget. This often results in hospitalization or death. Several studies have shown that death due to the lack of adequate health insurance exceeds the death rates from motor vehicle accidents.

You also state that “the public should learn … the folly …of expecting massive federal health care interventions to keep medical costs down.” Wrong!

Traditional Medicare, now 50 years old, has been doing so quite effectively. It is the only element in our current health care system with real teeth.

I wish the media would do a much better job of shedding light on the major problems we have in our country in how we organize and finance health care. For more than two decades, we have been plodding along on the theory that patients should have “skin in the game” and that we should rely on competition and the free enterprise system to control costs.

What has been the result? Our costs are nearly twice the average of the other advanced nations in the world. Our overhead is very excessive, i.e. too many chiefs and not enough Indians. We are the only advanced nation that fails to automatically cover everyone. Obesity is going up and our longevity has stagnated compared to other rich nations.

All of this is quite unnecessary. We can greatly reduce the rate of increase in health care costs in ways similar to our sister nations in the developed world. Our aging population problem is not as severe as many other nations. Furthermore health care is a booming area for job creation across the full salary range, especially for the middle class.

For details about the facts and suggested reforms, I recommend two respected organizations: the Organization for Co-operation and Economic Development ( and the Physicians for a National Health Program (PNHP. org)

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We are sorely in need of major reform.


Bridle Trail Drive

Johns Island

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