Big Payouts for Some Doctors, Too Little for Others

To the Editor:

Re “Health Law Lets Doctors Cash In” (front page, April 26), about how a new arbitration system under a consumer protection law has led to large payouts to doctors:

I am confused. In what universe is it normal for a dispute about a fee to be arbitrated so that one party ends up getting hundreds of times the amount that he or she asked for in the first place?

If a doctor sends a bill for what he or she feels is a fair amount and the insurance company comes back with a much lower figure, arbitration can be effective in determining what is fair. If I charge $500 for a procedure and the insurance company wants to pay me $150, there is room for arbitration. But for the arbitrator to then award thousands more to the doctor than he said his services were worth is incomprehensible.

As a member of the profession, I am ashamed that physicians would participate in this type of immoral gouging. Small wonder that doctors are losing the position of respect that we enjoyed for generations.

N. Donald DiebelWinter Park, Fla.The writer is a retired obstetrician-gynecologist.

To the Editor:

Focusing on outliers dangerously misrepresents the real threat facing patients: a nationwide practice of insurer underpayment that is destabilizing our emergency medicine safety net.

Emergency medicine accounts for over a third of all arbitration cases — more than any other specialty — because insurers consistently underpay for unplanned care. The No Surprises Act protects patients from surprise medical bills, but insurer practices threaten access to care.

Emergency physicians’ high win rate in arbitration isn’t evidence of gaming the system; it’s proof of systemic underpayment. Professional, neutral arbiters repeatedly determine that insurers’ payments are insufficient. Yet even after losing more than 85 percent of the time, insurers then fail to pay nearly 60 percent of arbitration awards within statutory time frames. These costly delays push our emergency medicine system to a breaking point, risking longer wait times and closures.

The real story is that an insurance industry is profiting by underpaying for care. Congress must pass the No Surprises Enforcement Act to impose meaningful penalties for nonpayment and protect the financial viability of emergency care for all Americans.

L. Anthony CirilloSaunderstown, R.I.The writer is the president of the American College of Emergency Physicians.

To the Editor:

Re “Trump May Send Afghans Who Helped U.S. Forces to Congo” (news article, April 23):

The Trump administration has reached a new low in the realm of imposed cruelty. The plan to send Afghans, now in Qatar awaiting U.S. immigration processing, to the Democratic Republic of Congo boggles the imagination. These are the very Afghans who not only helped the American forces in Afghanistan, but also probably saved numerous American lives there during the war.

Now, the administration proposes to deny them entry to the United States and send them to an unfamiliar foreign location on a different continent, where they will surely suffer innumerable harms.

How can our government condemn these friends of our country to an uncertain future instead of granting them the U.S. immigration status that they deserve?

Have we lost our conscience as a nation?

Robert LymanMinneapolis

To the Editor:

Tears came to my eyes as I read the story of Afghans who served alongside American service members as they battled the cruel Taliban fighters who took over their land.

After being parked like used vehicles in Qatar for more than a year, along with their wives and children, they are to be shuttled off to the Democratic Republic of Congo, even while some of them have families in the United States? Why?

Because we are led by an administration that judges humans by their religion and the color of their skin rather than by their actions and contributions to our nation. These Afghans have proved their worth by aiding our troops. Bring them to America, and they will continue to add value to our society.

Christel StevensUniversity Park, Md.