Answer to Medicare's problems lies in HSAs, and not in managed care

LETTER — Posted May 22, 2006

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Regarding "CMS: Care management pilot off to good start" (Article, March 6): The folks at the Centers for Medicare & Medicaid Services must be visiting here from another planet. They seem surprised that as the population becomes older, sicker and more informed about the health care choices available, expenditures have continued to skyrocket. Maybe they don't have intelligent life on their home planet.

CMS is suggesting that the increasingly unfair and outdated system of physician reimbursement for Medicare services be replaced with a pay-for-performance program.

Since CMS has done a miserable job with the current payment scheme, why should we expect them to do better with a much more complex metric quality?

How about trying capitalism for a change? Works great with computers, restaurants, etc.

How about a modified health savings account for Medicare patients so they, not some bureaucrat from another planet, can decide how and when to spend their money? It will never happen. I'll bet they don't have capitalism on their home planet, either.

Ed Charnock, MD, Desoto, Texas

Note: This item originally appeared at http://www.ama-assn.org/amednews/2006/05/22/edlt0522.htm.

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