Opinion: Managed care reform would help reduce the cost of health care


In his Aug. 16 letter, “Malpractice reform key to affordable health care,” Mark Kriss proposes that, “The single most important reform that would reduce the cost of health care is to finally rein in New York’s outrageous tort laws …” This is reminiscent of current political candidates for president saying such things as, the single most important thing to reduce the cost of gasoline in this country would be, “offshore drilling,” or “inflating your tires” or “harnessing the power of wind.”

In my opinion, there is no “single most important reform.” To say so leads to ignoring all of the other factors involved in the creation of the problem.

It is also an obvious matter of perspective based on self-interest. In the case of Mr. Kriss, executive director of NYTortReformNow.org, the bias is obvious. In my case, as a health care provider, while I can see the relevance of an objective debate of the issues surrounding the question of tort reform, my preference for declaring an issue “the single most important reform” would be “managed health care” and the profits declared by this country’s largest health insurance providers and their CEOs.

Over the past 5-plus years, my fees have not changed, yet my profits have declined to the point where they are virtually nonexistent, when considering my expenses for remaining in practice. The cost of malpractice insurance is certainly not my most significant expense and it pales in comparison to the gap between my fees and my reimbursements from health insurance. Fortunately, I am not dependent on my practice as a sole source of income.

When it comes to solving any complex problem in the 21st century, we cannot afford to focus on one potential solution at the expense of the others. However, when it comes to health care, I humbly disagree with Mr. Kriss and would vote for managed care reform as being “the single most important reform that would reduce the cost of health care.” It’s all in the eye of the beholder and, in and of itself, would have little lasting impact if we don’t address all of the major issues involved.

David R. Steindorf, Ph.D.

Clinical Psychologist


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