To the Editor:
Re “How Can We Afford $27,000 a Year for Health Insurance?,” by Zack Cooper (Opinion guest essay, Dec. 13):
In his essay on rising health care spending and the escalating costs of health insurance, Dr. Cooper should have added to his list of reforms ending the enormous health care billing fraud estimated to cost as much as 10 percent or even more of all health care expenditures.
This amounts to hundreds of billions of dollars and includes tens of billions taken away from Medicare. Prof. Malcolm Sparrow at Harvard, a health care billing fraud expert and the author of “License to Steal,” has called for far greater investigative and prosecutorial enforcement budgets to recover these thefts and to implement a strategy of prevention. Both Democratic and Republican administrations and Congresses have mostly ignored this commercial crime wave for decades.
It should be the subject of congressional hearings, leading to legislative action, given the bipartisan rhetoric supporting cost savings.
Ralph Nader Washington The writer is the consumer advocate.
To the Editor:
Zack Cooper points to a large, consolidated health care system and high administrative costs as among the main drivers of rising spending.
He’s correct, but we need to examine the root cause. While many like to point to America’s “free market” health care system as the reason for high spending, it’s anything but a free market. Americans have few choices among providers and doctors, and little knowledge of the real prices of care.
Third-party control from both the government and insurance companies has kept the market from being free, disadvantaging patients and eliminating competition.
Funding patients directly would give patients the power to choose care that works for them, force providers to compete for their business, and ultimately bring prices down and quality up.
When patients control their health care dollars and markets are truly free, affordability and access naturally follow.
Ge Bai Washington The writer is a professor of health policy and management at the Johns Hopkins Bloomberg School of Public Health and an adviser to Fund the Patient.
To the Editor:
This was an excellent article. Not only are we having the wrong debate about health care, we’re also looking at it from the wrong perspective.
Politicians and pundits continue to look at reforming health care from the top down — rearranging the parts and redistributing the money.
It’s time to look at reforming the system from the bottom up — from the perspective of middle-class families struggling to keep up. Why is there no limit to their financial obligation? Why are they faced with five-figure premiums, high deductibles and excessive co-pays?
If the policymakers in Washington can justify putting a cap on earnings that are subject to the FICA tax, why can’t they put a cap on the amount of money a working-class family has to pay for health care each year?
Let’s start with a simple idea, like limiting the cost of insurance to 7 percent of annual income and capping a family’s total out-of-pocket expenses at 15 percent each year. After all, isn’t making health care affordable what insurance is supposed to do?
David Loveland Chicago
To the Editor:
Zack Cooper’s essay on rising Affordable Care Act costs highlights more than increasing premiums — it exposes a growing crisis in access to mental health care. As premiums, deductibles and out-of-pocket expenses climb, people are forced to choose which care they can afford, and mental health services are often the first to go.
A national study found that adults with medical debt were five times more likely to forgo mental health care the following year. Even those with insurance delayed or skipped medical treatment because costs felt insurmountable.
When coverage becomes unaffordable, we see steep declines in therapy, counseling, medication adherence and participation in peer-support programs. This doesn’t just reduce access, it increases isolation, deepens distress and heightens the risk of crisis, especially among vulnerable communities.
Peer-support organizations like ours serve as a lifeline, but our work depends on people being able to access consistent care. Rising costs threaten to sever that connection, leaving needs unmet and communities at greater risk. Behind every insurance statistic is a real person making painful trade-offs, often at the expense of their mental health.
Liz Friedman Northampton, Mass. The writer is chief executive of Group Peer Support.
Australia Acts on Guns. The U.S. Should Follow.
To the Editor:
Re “Australia to Tighten Gun Laws After Shooting, Leader Pledges” (front page, Dec. 16):
What could possibly be more logical than the Australian leader’s sensible reaction to the sickening shooting deaths at Bondi Beach than to call for tighter gun laws?
While here in the United States we offer our thoughts and prayers, other nations, free from the grip of the National Rifle Association, act decisively to enact sensible gun safety laws.
Let’s not wait until our next Brown or Covenant or Sandy Hook or Uvalde. Wake up, America: The time for action is now.
Maris Thatcher Meyerson Berkeley, Calif. The writer is an executive producer of the film “American Solitaire.”
The post How to Reduce Surging Health Care Costs appeared first on New York Times.
