Letters: Jun. 19, 2006

(3 of 4)

Americans have finally cottoned on to what most foreigners living here already know. As an Indian studying in the U.S., I find even the most minor dental work prohibitively expensive and have scheduled medical procedures in line with vacations back home. Going to India for elective surgery is a very viable option: it's cheaper, Indian health care is world class, and the postoperative care is next to unbeatable. I was happy to read that Americans are finally discovering that good health care is not something only the affluent or insured can enjoy.

MEKHALA SAMSI Houston

Of course elective surgery is cheaper in India. Do the U.S.-trained surgeons there spend $100,000 a year on medical liability insurance? If malpractice occurs, can patients win enormous damage awards? Are local attorneys allowed to enter in a business-type contingency-fees partnership with a client, rather than charge ethical fees as all other professionals do? If I hadn't had to pay a fortune for professional insurance, I would have neither practiced the customary (but expensive) "defensive medicine" nor charged the fees I did. And I would have slept much better during my off-call nights. By the way, how do you say ambulance chaser in Hindi?

JOSEPH J. NEUSCHATZ, M.D. Port Jefferson, N.Y.

Nowhere in your story does it mention the real reason Americans cannot afford surgery in our hospitals. Health-care costs are rising despite the ever championed cause of tort reform, because of failed risky investments made by the insurance industry. Our well-lobbied legislators turn a blind eye as campaign fund raisers pass the buck to the health-care system and blame malpractice damages for skyrocketing costs.

MICHAEL EBER West Bloomfield, Mich.

TIME's table comparing the prices for medical procedures in the U.S. and Asian countries showed that U.S. hospitals charge uninsured patients twice what they bill an insurance company for the identical procedure on an insured patient. That lamentable and unethical practice should be the shame of hospital administrators everywhere. In effect, they put the screws to those who can least afford it.

ELMER FUNKHOUSER Concord, Mass.

Empathic Medicine

"Teaching Doctors to Care" [May 29] reported on medical students' learning about the frustrations of the chronically ill. It is clear to anyone with a lick of common sense that doctors who are aware of patients' whole experience are able to provide better care and also save money. The HMO-dominated, profit-driven medical community is blind to the long-term costs of not resolving patients' health issues because it is so overly focused on the cost of a single test.

ADAM SIGNORE Medway, Mass.

Until a doctor understands how a disease affects a patient's social life, daily routines, family interactions and anxieties, she or he does not really know that disease. A physician can gain credibility with patients and their families by asking how a disease is affecting their personal lives. Patients will feel understood and will be more likely to comply with the doctor's suggestions and instructions.

LOREN J. BARTELS, M.D. Tampa, Fla.

Immigration Anxiety All Over