Dear Ms. O'Connor,

Before I begin this letter, I would like to thank you for allowing me to voice my opinions and concerns regarding our health care system of today.

Sad but true, I can sum up the downfall of our health care system with one word: GREED. Like an aggressive cancer, it has slowly ravaged and eaten away at every aspect of the health care system leaving it weak and vulnerable. Although there is no "quick-fix" for this terribly selfish, me-myself and I want the whole pie attitude, I hope that by breaking down the word it will help us realize the gravity of the health care situation and the steps we can take towards slowly regaining strength so that once again heath care can be a viable, successful and caring industry.

G -- Grasp. We need to grasp what the real problem is in the health care system and what went wrong. Like the ongoing feud between the Hatfields and the McCoys, the physicians are blaming the insurance companies (HMO's and PPO's) and the insurance companies (HMO's and PPO's) are blaming the physicians. I have been associated with the medical field since 1969 and have seen many many changes; some of which were beneficial and some which in my opinion were not. Having been on both sides of the fence as a patient and employee, I blame both feuding parties in some cases. I have seen where physicians have ordered tests which I felt, too, were unnecessary as there was a more appropriate test that could have been performed, eliminating several other tests prior to that. I have seen where surgeons charge postoperative visits within three days of a $10,000 surgery to insurance companies without any "global" package. I am well-aware of all CPT and ICD-9 coding practices as I have done so for over 10 years in several different areas and for years the insurance companies have always paid claims without ever batting an eye. Someone has finally stepped in and said "Whoa! Was this test really necessary? Or, could another test (more cost-effective) have produced or lead to the same diagnosis? Or, shouldn't there be some type of global package once a surgery has been performed? The physicians now feel threatened as they are being scrutinized over their shoulder, so to speak, and I do feel insurance companies are justified in that respect. I feel ALL claims should be examined thoroughly before payment is issued and if the turn-around takes longer than normal, than so be it. I do feel in all fairness, that insurance companies are now hiring "auditors" to inspect the claims before payment is issued. (I personally would love to hold a position such as that). The average person pays a lot for insurance - whether their employer pays part, all or none at all. Every time a patient uses their insurance and a claim is paid, this only puts that person at a "higher risk" and their premiums are likely to increase because of their chronic use of the insurance. Insurance is expensive. I myself paid in $7000 out of my own pocket to insure my son and husband last year. The physicians complain that insurance companies are telling them HOW to treat the patient and I don't think that is totally true. I merely think the insurance company, like everything else today, is just trying to be frugal with patients investments.

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