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FP Report
March 2001 • Volume 7 • Number 3
Letters to the Editor

Against Medicare drug benefit

To the editor:

I understand that the Academy supports a prescription drug benefit for seniors as part of Medicare (see "AAFP responds to early initiatives of Bush, Congress"). Stop and think:

  1. Medicare has always been fiscally unsound. The only way politicians keep it afloat is by increasing taxes or reducing physician payments. Another benefit would require payment cuts or increased taxes.
  2. Is it within the founding forefathers' ideas that we should establish a social welfare program for a societal segment? And is using age as an entry criterion consistent with our other nondiscrimination tenets?
  3. Payment for a Medicare office visit is below my cost. Adding a benefit that funnels funds away from caregivers to drug companies will not improve FPs' plight.
  4. Accepting assignment is a flawed premise. One of my patients is worth millions but is very healthy. Medicare is his only insurance. I have to accept from him less than my office expenses for his visit.

Medicare should pay a certain amount for a visit or for labs, X-rays or whatever, according to a schedule. The physician should be able to bill for or write off the additional. What hurts FPs is that private insurers have adopted this Medicare model. When they don't pay, we're stuck.

Try concentrating AAFP's efforts on fighting for what is good for FPs. Quit focusing on social and socialistic issues. When your members are properly compensated, without the major hassles involved in insurance today, then the patients also benefit.

John Fieler, M.D.
Houston

Another breast-feeding obstacle

To the editor:

I agree that physicians need to promote breast-feeding as normal. However, another obstacle was not mentioned in the January FP Report article on breast-feeding. Many of my patients who would be interested in breast-feeding, but do not, cite problems at work. There is no place to pump or store milk and no support from supervisors to do so.

I doubt that breast-feeding rates will increase much until it is seen as a societal good and employers are encouraged to offer opportunities for mothers to nurse their babies at work or to pump and store breast milk.

Being my own boss in solo practice, I was able to make my own rules. My baby was in a day-care center a few blocks from my office. I made sure almost every day that I went to see her at lunch to nurse her until she weaned herself when she was 1 year old.

Teresa Beckman, M.D.
Evansville, Ind.

Health care coverage for all

To the editor:

I feel strongly that we should have universal health coverage (as the AAFP recommends in its proposal described in the December 2000 and February 2001 issues of FP Report).

Practically, it would cost less to have a screening M.D. or R.N. in emergency rooms and refer patients not really in emergency situations to their personal M.D. than to treat all the patients, as we do now, at a cost of $200 to $500 for conditions that could wait.

By reducing what we spend to keep nuclear weapons on unnecessary alert, we could find the funds.

M.A. Glover, M.D.
Nanakuli, Hawaii

To the reader: Write us letters of 200 words or fewer (subject to editing), using the FP Report address pbinder@aafp.org or FP Report, 11400 Tomahawk Creek Parkway, Leawood, KS 66211-2672.

FP Report is published by the AAFP News Department.
Copyright © 2001 by American Academy of Family Physicians.

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