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Legal or Illegal Price Fixing: The Same Effect

Dear Editor:

Here in the state of Illinois, it is illegal for one business owner to collaborate with another to fix prices. The purpose of this law is to preserve the "free market" and to protect consumers from artificially high prices. To get around price-fixing laws and free-market forces, hospitals in our area and throughout Illinois have bought out private physician practices and made the doctors employees of the hospitals. Today, private physician offices are a rarity and more than 90 percent of doctors (estimate) are hospital employees. The opposite was true 25 years ago.

The net effect of this is that a couple of large medical corporations in a community set all the fees (including doctor fees) and make all the policies for health services. This essentially eliminates the free market, negates price-fixing laws and puts enormous power over health care into the hands of non-elected boards. It also takes $100’s of millions of taxable property in each community off the tax rolls.

When we study the history of our country, we see the negative effects monopolies had on the lives of the common citizen. Profit-hungry corporations had the leverage and money to fix prices, buy influence, enact laws, and form public opinion to eliminate competition and maximize profits. Appropriately, anti-trust laws were enacted to break up these monopolies and restore free enterprise.

Today, medical centers are extremely profitable and charge exorbitant fees to the public . The chief executives and numerous doctors in these "nonprofit" corporations receive salaries plus bonuses that approach or exceed a million dollars a year each. (See Form 990s available online or from medical centers.)

The 6 percent donation (in Illinois) toward free services required by the government for these medical centers to qualify as nonprofits is just the cost of doing business. For this small price, they are given free rein to make medical care by far the most expensive and profitable in the world; and at the same time, pay not a penny for federal, state, and local taxes - while receiving millions in tax-free donations.

Economists estimate health care costs will rise by the end of this decade to exceed 25 percent of the GNP. We must stop this trend by breaking up medical monopolies, revoking the nonprofit status of medical centers and restoring the “free market” to health care.

Don Selvidge, DC
Mattoon, Ill.

Editor's Note: The following letter to the editor clarifies information presented in Dr. LeRoy Perry’s recent article (May 15 issue) and addressed in a subsequent letter by Dr. Jeff Weber (Aug. 15 issue).

Dear Editor:

As I was the one who gave the USOC Dr. George Goodheart's name and set up the first meeting (at Englewood Hospital) in 1979, which ultimately sent him to Lake Placid; as well as recently published the first comprehensive History of Sports Chiropractic (where all of this is documented in full), I think I can settle this matter once and for all.

Dr. Goodheart was the first U.S. Olympic team DC and actually went to Lake Placid for the XIII Olympic Winter Games in 1980. It is true that he was initially considered for the Summer Games in Moscow, but due what was in retrospect a rather moronic decision by President Jimmy Carter to retaliate for Brezhnev's invasion of Afghanistan, we didn't go. This was the infamous boycott of  the Moscow Games, and the U.S. team was more or less extorted into "volunteering" not to go. (That's another tale.) This is why Goodheart went to Lake Placid.

Dr. Perry certainly did make a major play to get in with the U.S. team there, but a decision had already been taken by USOC to take George instead. And he did function as a doctor there, albeit under a very strict protocol.

By 1984, there was a feeling in the committee that they had "rid themselves of the chiros," but the athletes, at least in part due to continued lobbying by Dr. Perry, kept up the pressure, and Dr. Eileen Haworth was taken due to a connection through her husband, a podiatrist with the track team in California at the time.

Thus, George Goodheart was certainly the first U.S. Olympic Team DC, and Eileen the second. Dr. Perry has the distinction of being the first DC to serve as a team doctor at any Olympics, as he apparently went to the Montreal Games in 1976 and may have been at an even earlier Olympics as team DC for the tiny island nation of Aruba - which, by the way, today boasts that its Minister of Health is a DC!

Stephen J. Press, DC, PhD, CCSP, FACSM, FICC, ICSSD
Founder and Past President, FICS

A Sensible Solution to the Medicare Problem

Dear Editor:

I have been treating Medicare patients for 32 years and have always enjoyed helping them. In recent years, I have also read numerous articles in this publication about our profession's poor record-keeping and other issues with treating and billing Medicare patients. Many of my Medicare patients have very chronic conditions that realistically will not be completely resolved. Yet they choose to come to my office for good chiropractic treatment instead of their MD because it helps them and improves their function.

All my Medicare patients are advised that if Medicare denies their treatment due to a medical-necessity issue, they are responsible for payment. This is done with the Advanced Beneficiary Notice, which I am sure everyone is using. If I appeal a denial, I spend more time on the appeal than on the treatment, and for no pay. This does not happen often, as I do not treat Medicare patients with a high visit frequency. My Medicare treatment notes are much longer than my other patient treatment notes and take me longer to fill out because they include all of the PART findings, etc.

There is a better way, in my opinion. The Centers for Medicare & Medicaid Services should offer a fixed chiropractic benefit of a certain number of visits per calendar year. This could be between 12-24 visits per year, like 90 percent of the private health insurance plans I bill.

This would take the pressure off both the doctor and the patient, as everyone would then know what is covered and what is not covered. If a patient used up their visits for the year, they could just self-pay for any additional treatments. Of course, this sensible solution would put the countless number of CMS-contracted reviewers looking at our claims out of work - or they could be put to work reviewing hospital bills.

Ken Lawver, DC
Manteca, Calif.