To the editor:
Concerning “Why I quit my job as a health insurance manager», by Wendell Potter (guest essay, December 20):
The problems with private health coverage cannot be solved by incremental changes. They are inherent to the system. Health insurance companies don’t make money providing care; they make money by refusing payment. They take advantage if an expensive patient has had enough and takes their business to another company.
The only answer is universal public health coverage, sometimes called “improved Medicare for All.” Washington is unlikely to provide that. Fortunately, states can lead the way, as they have since America’s founding.
Free public education, abolition of slavery, labor laws, anti-discrimination laws, and many other forward-looking policies began at the state level.
Richard N. Gottfried
new York
The writer is a retired member of the New York State Assembly and chairman of its health committee.
To the editor:
Having spent the last 20 years in the health insurance field, I find this essay to be a low and misleading blow against the insurance industry. Health insurance certainly isn’t perfect, but the industry cares for hundreds of millions of Americans while navigating an exceptionally complex system.
What Wendell Potter calls “consumerism” does not tend to improve Cigna’s shareholder value by reducing medical costs. More than 80 percent of Cigna’s employee-sponsored enrollees are covered by self-funded employer groups. In other words, the employer assumes the entire risk of medical expenses and any remaining funds go to the employer, not Cigna. Self-funded high-deductible health plans are an effort to shift medical costs from employers to their employees.
Many employers, including mine, offer their employees options for high-deductible plans and lower-deductible plans. There is a compromise. Lower deductible plans cost more each month but protect the insured in the event of a catastrophic injury or illness. High-deductible plans cost less each month, but can result in large medical bills if disaster strikes.
Authorizations and denials can be a real headache for the provider, insurer, and policyholder, but they exist because the health care industry ran amok for decades in their absence. We’ll talk about it another time.
Michael Keyes
Saratoga Springs, New York
The author is an executive in an electronic health records and interoperability platform.
To the editor:
I have a similar story to Wendell Potter. I, too, worked for a large insurer and left my job in 1998, 10 years before Mr. Potter, after making one promise too many that I knew we couldn’t keep. As an account executive responsible for large corporate accounts, I frequently spent my days explaining to CFOs why large hospitals and their affiliated physicians were excluded from our network (even though their presence in our network had been a selling point). sale) or why certain procedures were not covered.
I have seen senior leaders at my company make decisions that diminished our ability to provide service because leaders placed a greater emphasis on shareholder returns. I swore I would never work for a public company again.
Over the years, I have become convinced that universal health insurance is the only solution. This would actually benefit most large companies, as it would allow them to remove their massive health care debts from their balance sheets.
Andrea Hale
new York
To the editor:
Growing up in Montreal, I saw the universal health care system up close. If you needed imaging, you would pay nothing out of pocket but would wait six months for the MRI or CT scan. Or you could pay $500 and receive the same medical service in the afternoon – a two-tiered, wealth-based system that is contrary to the intent of universal health care.
When my mother was older, she slipped on an icy sidewalk and broke her hip. She spent three months in a rehabilitation hospital. When she was discharged, telephone charges totaled $65. It looks good. Sure, the rehab center was and looked like it was from World War II.
The downside of telling real-life horror stories about America’s for-profit insurance industry is that we tend to gloss over alternatives. It turns out that non-profit systems, like Medicare or Medicaid, and universal health systems, like those in every Canadian province, are often neither better nor worse than for-profit provision. All provide less medical care than our insatiable appetites would desire if we could not have to pay out of pocket, not have lines, and not be housed in cheap motel-style health care facilities.
Paul Greenberg
Brookline, Mass.
A police failure in New Orleans
To the editor:
Concerning “Festivities turn into horror in New Orleans» (first page, January 2):
Police work is not rocket science. Often, planning to prevent criminal activity is common sense. What happened in New Orleans was predictable given that a similar event a deadly attack took place in Germany very recently, and the fact that in recent years there have been more than a dozen terrorist incidents involving a vehicle throwing himself into a crowd.
I am a retired Deputy Police Chief with over 25 years of experience. In police work, there is a maxim: if it is predictable, it is preventable. This is a monumental failure on the part of the New Orleans Police Department, which resulted in the needless deaths of innocent people.
Although hindsight is always 20/20, foresight can also be just as accurate. The fact that the bollards – steel pillars installed on sidewalks and streets to keep vehicles out – were removed for maintenance purposes was a huge downfall for the city.
The job of the police is to constantly invoke the “what if” scenario. It was not difficult for this terrorist to overcome the weak blockade put in place. The terrorist involved in the New Orleans attack was able to bypass a parked police vehicle and use the sidewalk to carry out his deadly plan.
The burning question is why New Orleans hasn’t followed New York City’s lead and place garbage trucks block vehicle access?
The possibility of this attack was foreseeable. And it was most certainly avoidable.
Len DiSesa
Dresher, Pennsylvania.
Making polluters pay
To the editor:
Concerning “New York law makes polluters pay for climate» (first page, December 27):
A billion tons of pollution globally over the past 24 years is a very big waste caused by fossil fuel companies. Science tells us that this greenhouse gas pollution is dangerously altering our fragile atmosphere, causing insidious fires and floods, monster storms and deadly heat waves.
We must desperately fight this climate crisis. Making polluters pay is both intelligent and fair!
This new bill signed by Governor Kathy Hochul is perfect. This imposes fines on polluters and raises significant capital. These funds will be used to repair damage caused by climate events and allow New York to become more resilient to future climate events.
It’s a very big moment. Hopefully other states will follow suit and we can begin to effectively mitigate this looming climate crisis. Perhaps the New York Legislature will commit to smarter climate action next session. This news heralds a much happier new year!
Sally Courtright
Albania