Re: "What the Republican Plan Gets Right"

To the editor:

Mark Siegel (5/6/17, What the Republican Plan Gets Right) makes an absurd argument to justify the Republican plan to charge higher premiums to some patients and not others.  He speaks of a patient who 'insists' on seeing him too frequently for her seasonal allergies and asks 'shouldn't a patient who continues to see me unnecessarily pay more?'  

No. The physician is not an indentured servant.  If his treatment is  'unnecessary' why is he delivering that care? And how is the insurance company paying for treatment that is not medically necessary? Dr. Siegel points to the patient's low copay supporting this misuse but he places too little responsibility upon himself for taking his time and the insurance company's money to 'reassure', apparently without success, his patient.

Patients with a tendency to over utilize the health care system often suffer from an undiagnosed psychological problem - typically an anxiety disorder or depression.  Perhaps if reassurance is not effective, Dr. Siegel should  suggest his patient see a physician who can more effectively treat her worry.

Respectfully submitted,

Larry S. Sandberg MD