Todd Rothenhaus, M.D.
Chief Medical Officer, athenahealth, Inc.

Dr. Solomon responds:

Dr. Rothenhaus offers an interesting perspective, and his title suggests intimate familiarity with for-profit enterprise in health care. But I cannot help finding it remarkable that he appears to defend the SGR, which would seem to place him in a very small minority of U.S. physicians.

Virtually no one on Capitol Hill defends the SGR as a good idea, noting only that fixing it will be quite expensive.

If there is some rational line of argument that revenues are better spent on shareholder dividends than on new plant and equipment, I eagerly await it and would happily sit through another year of college economics in which Dr. Rothenhaus could explain that to me.

Defense of Pharma as the line of business with the largest profit margins in our market economy is unlikely to find many nodding heads among those who struggle to make choices between buying groceries and paying for their prescription drugs.

Finally, I’m still waiting for the explanation of the practical benefits of taking some of the health insurance premium dollar and diverting it to higher administrative costs and shareholder capital gains, instead of having it pay for health care, which is what the folks who poured it into the risk pool rightly expected.