JIM STERGIOS'S Op-ed ("Doing the math on healthcare," July 22) was a wrongheaded, though perhaps understandable, reaction to the current climate as we wrestle with burgeoning healthcare costs. We're big fans of Massachusetts' healthcare reform but, as we now know, its success has spurred many unintended or unforeseen consequences.
However, the solution to the issues of greater-than-anticipated health insurance coverage and thus underestimated costs is not to arbitrarily reduce payments to a medical institution that provides the highest level of care to low-income and uninsured patients - certainly not without first examining the consequences.
Stergios says "one must assume" that reform has significantly reduced the burden on hospitals like Cambridge Health Alliance. But one would be wrong. The number of visits by needy, low-income populations has not declined (370,000 visits by Medicaid, Commonwealth Care, and uninsured patients this year despite declining revenues for such care). Implementation has actually negatively affected finances. Nevertheless, Cambridge Health Alliance is evaluating alternatives and making tough decisions in order to accommodate the changing landscape.
There are great challenges ahead for Massachusetts and Cambridge Health Alliance to guarantee further success of the reforms while maintaining high-quality care for the most needy. Tackling these complex challenges will require the same thoughtful partnership that has propelled the Massachusetts healthcare experiment this far.
DENNIS D. KEEFE
Chief executive
Cambridge Health Alliance
Cambridge
I TAKE strong exception to Jim Stergios's notion that the "only way . . . in the immediate term" to address rising health costs is on the backs of two specific providers, Boston Medical Center and Cambridge Health Alliance.
Since enactment of healthcare reform, BMC has held up its end of the bargain. It has converted more free-care patients to Commonwealth Care than all other hospitals combined, and has reduced its free-care patient population from 25 percent to 7.2 percent of patients served.
Stergios urges a focus on individuals, not institutions. He should know about the people who visit BMC. Thirty percent do not speak English; BMC's Interpreter Services Program is the most extensive in New England. Often, medical problems are rooted in hunger; BMC's food pantry services 65,000 homes yearly. Diabetes is a silent killer in communities such as Mattapan and Roxbury; BMC is the hospital with Boston's best inpatient insulin management program. Cutting payments to BMC means a loss of these programs.
A healthy BMC is essential to our community, our healthcare system, and most important, its patients.
Government's recognition of that goes deeper than any "political deal." It reflects who we are as a Commonwealth.
MARSHALL N. CARTER, Chairman
Board of trustees, Boston Medical Center
