David Lazarus' wife spent eight nights in the intensive care unit of the UCLA Medical Center. Last year, my wife went into a coma at home. I was able to quickly and safely transport her the two miles to the local emergency room, where an MRI scan revealed a problem that required a neurological ICU unit. UCLA refused the transfer, but Cedars-Sinai accepted her.
Four days in the ICU and a fifth elsewhere in the wards resulted in a hospital charge of $162,000, which was reimbursed by Medicare for $120,000. The five specialists involved split $1,500.
FOR THE RECORD:
Healthcare: A July 4 letter to the editor incorrectly said that care at the UCLA Medical Center will be unavailable on the insurance exchange Covered California. In fact, UCLA will be available via Anthem Blue Cross. —
My wife recovered. Yes, the technology and treatment were incredible. But why the disparity in reimbursements between the physicians and the hospital?
We have a superior but dysfunctional system that cannot survive in its present form, and Obamacare only perpetuates it. Health insurers have
created this disparity by accepting inflated prices from the hospitals. Maybe they — and the profits and waste they cause — are expendable.
Jerome P. Helman, MD
I enjoyed Lazarus' account of the excellent care his wife received at UCLA Medical Center.
Unfortunately, this medical group is not offered through Covered California, the insurance exchange created in accordance with President Obama's healthcare
reform law. Cedars-Sinai is also not available through the exchange. If you want a subsidy through the exchange, you will have to change doctors. This is how access to the "higher levels of the system" will be rationed as Obamacare is rolled out this October in California.
The insurance companies had to use their third-tiered networks to compete on price within the exchange, leaving many top-tiered providers and hospitals excluded. If you have an individual policy outside the exchange, you can keep it, but you will not get a subsidy. The subsidy is only offered on the plans within the exchange.
I hope that Lazarus' wife will be able to continue her care at UCLA when these changes occur.
Lazarus' wife, you got great care. Now the real headache will begin.
I had a simple exam and a biopsy at UCLA recently, which required two visits total. It took two full years to get the bill sorted out.
And it's not as if I'm uninsured. I have a Motion Picture Health and Welfare plan, and UCLA is in network and a member of our referral network.