It is unfortunate that writers like Marc Green (Editorial Pages, Jan. 9), "Hospitals Cut Costs, the Poor Bleed," persistently buck the trend toward competition and cost-control in health care. Marketplace competition and adequate care for the poor are not mutually exclusive goals. It is possible--indeed, vital--to achieve both.
A health-care system that has no incentives to hold down costs--a system that discourages competition and a government that, until recently, paid all Medicare bills with no questions asked--is bound to encourage overcharging, unnecessary treatment and fraud. Often the direct victims of these abuses are elderly, and the indirect victims are the taxpayers, who pay for fatter government program costs as well as higher health-care costs and insurance premiums for themselves.
The federal government has a duty to guarantee all Americans access to quality health care, regardless of income. Clearly, steps must be taken to see that the poor do not become casualties of a competitive health-care system. One small example is legislation (now in a House-Senate conference committee) prohibiting hospitals from denying emergency care to indigent patients. We intend to do more, particularly to ensure health coverage for the estimated 37 million Americans who now have no health insurance, public or private.