I am saddened by Barbara Calder’s plight (“How U.S. Health System Can Fail Even the Insured,” page one, Nov. 16.) Unfortunately, most Americans seem to think that their insurance company is in business to care for their daily medical needs. The fact is that the for-profit insurance companies exist as business entities to create profits for shareholders and prevent financial catastrophe to the insured. Patient premiums are the means by which such profits are generated, and any payments made for medical care that can be denied (e.g., a referral to a specialist or a drug like Celebrex) fail the insurer’s fiduciary duty to shareholders. As I explain to my patients daily, their homeowner’s insurance doesn’t pay for the plumber to fix the clogged drain, and their car insurance doesn’t pay for a tune-up or gasoline. Those insurance policies are purchased to prevent financial catastrophe in the event that the house burns down or the car is destroyed in a wreck. Our current health-care system is in disrepair, but part of the blame must go to patients. Ms. Calder could have chosen to actually pay the specialist had she truly valued the advice she was seeking. In the current system, an internist such as myself who agrees to participate in health plans gets paid less to care for a critically ill patient than my plumber gets to fix my leaky toilet. It is for this reason that I have decided not to accept many insurance plans. My patients and I value my time and expertise, and realize that if you don’t have your health, not much else matters. Perhaps that is why I have the time to spend with patients and have diagnosed four cases of Ehlers-Danlos syndrome in the past year alone. Lyle D. Kurtz, M.D.
Diplomate, American Board of Internal Medicine
Beverly Hills, Calif.