In her July 22 letter, “The right way to fix medical billing,” Deb Sanderson says the government should not be allowed to determine reimbursement rates for hospitals as suggested in some proposals before Congress. She does admit there is a problem for consumers.

Her approach does not ask why an MRI can cost $1,200 in one place and $2,500 in another. We must consider some basic facts, three of which have little to do with government control.

First, costs vary widely between existing health care systems. Costs vary not because the procedure is different but because provider costs vary. Second, our declining rural population does not support a hospital in every town. Providers have been consolidating in health care systems for years now, at least partially in recognition of the need to more efficiently manage costs. Third, preventing the need for expensive tertiary treatment reduces cost.

Republicans have been telling us that government control will not work, completely ignoring that government manages Medicare at substantially less cost than insurance through private insurers. Medicare, with existing supplements, provides very good coverage at relatively little cost to the consumer.

Why won’t that work for the general population? Somehow it does work in most industrialized countries.
Some pol calls it socialism and that ends the discussion for many of us. If it did not, we might, as taxpayers, demand that government work with communities to identify cost drivers (those factors in our states and local communities that result in poor health outcomes and huge costs) and take action to remove them. For example, the largest block of health care dollars goes to chronic care patients with conditions that were preventable.

As voters we need to tell the pols that scoring political points will have to cease in favor of the common good.

Dean Crocker
Manchester and Estero, Florida