The Letter to the Editor by Robert A. Goldstone, MD, (April 1995 Bulletin) says it all in a very subdued and logical tone. Managed care organizations (MCOs) are not for ethical and entrepreneurial orthopaedists. It is painful when I read in the Bulletin about how we are advised to try and live within a new system that is inherently noxious and uncaring.
In my opinion, MCOs do nothing of a helpful nature. They exist on monies taken from physicians and hospital fees. They do nothing of a helpful or creative purpose for the patient. They exist because insurance companies have been given free reign to do what they want in the health care arena, and have come in like a bunch of storm troopers dividing the patients that are out there, trying to sell groups of people on their insurance, stating that their plans offer more for less cost.
We all know the truth. They exist by cutting fees and these funds, in turn, line their coffers. Patients are denied procedures they need on a regular basis, and hospital length of stays are trimmed to painfully narrow parameters.
It is painful to see the Bulletin of my organization tell me how I should try to live within those parameters that the insurance companies have established. I for one hope to keep my head high, to practice the best way I know how, and to give my patients the service and care that they have come to expect of me.
I will not march to the tune that the insurance companies play, and I believe many self-respecting physicians in my situation will probably end up doing what I am going to do: retire early, retain my self-respect, and avoid the ulcers and anguish of life with the MCOs.
Donald J. Holtzman, MD
Cal Thomas, the presidential guest speaker at the 1995 Annual Meeting in Orlando, discussed, in part, the growing problem that physicians face as they are asked to deal with moral debates such as the priorities of their profession embodied in managed care, health care rationing, and euthanasia. Thomas, a nationally syndicated newspaper columnist, cited a Dutch government report and other sources that there have been incidents of involuntary euthanasia in the Netherlands.
In a letter to the Academy, J.M.G. Lanphen, president, and Th. M.G. van Berkestijn, secretary-general, of the Royal Netherlands Society for Promotion of Medical Science, objected to the statements, saying, "the discussion was a succession of falsehoods, concoctions, insinuations, and distorted facts...." Statements that the handicapped, the elderly are afraid to go to hospitals because they are afraid of involuntary euthanasia are "not based on facts...and completely inconsistent with the truth," the officials said.