The Bitter Pill: The Health Care Industry Responds

Letters on TIME’s special report

COMPLETE COVERAGE: Why Medical Bills Are Killing Us

No one could disagree with Steven Brill [“Bitter Pill,” March 4] that health care finance is broken. It is wrong, however, to suggest that the beneficiaries of this dysfunction are not-for-profit hospitals like Stamford Hospital. Contrary to what Brill says, Stamford Hospital does not lack a financial-assistance program; we provided assistance to almost 11,500 patients in 2011. Was Brill’s story of an uninsured Stamford Hospital patient facing unreasonable charges accurate? Did our financial-assistance program work with the patient to reduce the bill to an affordable level or even write it off completely? Brill refused to share the patient’s name or the complete bill, so we are unable to answer those questions. We support meaningful reform in health care finance. But Brill’s scare stories do nothing to advance the dialogue.

Brian G. Grissler, President and CEO, Stamford Hospital, STAMFORD, CONN.

STEVEN BRILL RESPONDS: Stamford Hospital was shown the bill and never disputed its authenticity. I made clear in the article that the hospital settled for cutting its bill in half.

Within the U.S. health care system, medicines offer the greatest value for improving the quality and length of life for patients and helping control overall costs. Investment in research and development is critical to improving lives and fostering economic growth. Member companies of the Pharmaceutical Research & Manufacturers of America alone have invested over $500 billion in R&D since 2000. Policies intended to improve our health care system should protect, not thwart, the innovation that will lead to the next generation of treatments and cures.

John J. Castellani, President and CEO, Pharmaceutical Research & Manufacturers of America, WASHINGTON

Today’s hospital bill is a symptom of a broken payment system. Nationally, hospitals deal with more than 1,300 insurers, each with different plans, all with multiple requirements. Patients may look at a hospital bill and think the prices reflect only the direct care they received, when in fact what’s reflected are all the resources required to provide the care. We recognize that health care is expensive, and hospitals have worked hard to hold down costs. Consumers deserve meaningful information about the price of their hospital care, which is why we support legislation that would require all states to provide this information to patients.

Rich Umbdenstock, President and CEO, American Hospital Association, WASHINGTON

Part of the problem for hospitals is caused by insurance companies. I was for many years the administrative director of a large urban emergency department. In order to contract with insurance companies, we had to offer a discount. We could not afford to discount our already low prices. So we had to raise our prices to offer the discount to the insurance companies–and it turned out that the discounted prices were higher than the prices we originally charged. Go figure.

Kate Reeves, R.N., MOUNTAIN CENTER, CALIF.

After a typical 10-hour day involving 25 patients and 137 phone calls, I have just completed Brill’s review of the American medical system. It aptly reinforced what my peers and I already know–that while we fight each day for every dollar to keep our practices afloat, administrators and special interests are compensated like professional athletes.

R.J. Umansky, M.D., ROCHESTER, N.Y.

One solution not mentioned is to require all hospitals and outpatient clinics to post their complete chargemaster price lists on the Internet with the code for every item explained, so we know how much they are charging for aspirin. That would help change their seller’s market into a free market.

Sylvia Wendell, MENANDS, N.Y.

I am blessed to have good health insurance provided by my employer. But I have far too many hardworking friends and relatives who have no health insurance. I have long been puzzled and deeply disturbed by the vast difference in what I have to pay (or what my insurance company is charged) for health care and what my uninsured friends pay. Brill’s article was a revelation.

Hannes Dietrich, ANNVILLE, PA.

Your article on the high cost of health care is not accurate when it comes to small hospitals. Ours is a small, 18-bed hospital that provides a range of inpatient, outpatient and surgical services. Small hospitals throughout the country are struggling to serve their communities in the face of increasing federal regulations and decreasing payment. Including them in the same category as the large hospitals in your article is unfair.

Jeffrey K. Meyer, CEO, Osceola Medical Center, OSCEOLA, WIS.

Trials of the Pentagon’s F-35

I was disappointed that Lockheed Martin, builder of the F-35 program, was not contacted for Mark Thompson’s story “The Most Expensive Weapon Ever Built” [Feb. 25]. The F-35 has conducted weapons-release testing on multiple occasions, and the helmet Thompson claims is “plagued with problems” has been used by pilots on more than 4,000 F-35 flights to date. Time said the software needed to go to war “remains on the drawing board,” when in fact only 10% has yet to be developed. And the cost of the F-35 is decreasing: since the first production jet was delivered in 2011, the cost per unit has been cut in half.

Orlando Carvalho, Vice President and General Manager of the F-35 Program, FORT WORTH