Readers React: Does California want a major healthcare shortage? Because adopting price controls would cause one

To the editor: Putting a state commission in charge of directly regulating the prices of healthcare is too simple a solution to a complex problem. It will drive some providers out of the state, limit the expansion of other healthcare services to keep pace with population increases, and it will force providers to prioritize cost over quality and access. (“An ambitious California bill would put the state in charge of controlling prices in the commercial healthcare,� April 9)

Already, many providers do not accept Medi-Cal, and many are no longer accepting Medicare because reimbursements are too low. By capping healthcare revenues without capping the expenses of healthcare providers, the state would be penalizing providers.

In no other area do we have centralized state control over a large part of the economy. Price controls have an awful history in the U.S. and other countries, often leading to shortages of goods and services. We need a better solution.

Michael E. Mahler, M.D., Los Angeles

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To the editor: I would love to see the state oversee the out-of-control prices charged by doctors, hospitals and other medical providers. At the same time, I am doubtful that such legislation is realistic.

Here’s a less drastic proposal — one that might stand a chance of passage — intended to deal with the epidemic of providers who refuse to accept Medicare and Medi-Cal patients, and who increasingly limit their practices to a “concierge care� model, which only the well-to-do can access.

The proposal is this: Roll back the protections afforded doctors, hospitals and other medical providers by MICRA (the out-of-date 1975 medical malpractice “reform� limiting damages) such that it would only apply to providers who certify that they will accept Medicare and Medi-Cal patients on a nondiscriminatory basis and that they will disclaim “concierge care.�

Put doctors (and their insurers) to the test. Let them choose between MICRA or restricted access.

Ralph Mitzenmacher, Altadena

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To the editor: If the state set prices for healthcare, maybe I wouldn’t have seen these entries on my bill for an overnight hospital stay:

• $441 for physical therapy, which was for someone who asked if I could stand unassisted.
• $624 for speech therapy, so someone could determine for five minutes whether I was able to talk.
• $2,016 for observation hours (nursing care). This breaks down to $126 per hour for 16 hours of care — except that the care was not constant. A nurse popped in at odd intervals for a few minutes each time.

This was a Kaiser facility, so I paid $50 for this adventure while Medicare took a huge bath. The total bill was $9,863.55, and I was discharged without a diagnosis.

Mike Auer, Encino

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