Kudos to The Democrat, in general and to Adam Koob, in particular, for the excellent article (March 9) on the problems facing our hospitals in town, specifically Natchez Regional.

Having represented county hospitals for the National Association of Counties in Washington, D.C., many years past, I can read that nothing much has changed.

As healthcare costs skyrocketted in the 70s, so they continue to do in the first decade of this century. As Congress cut Medicare and Medicaid reimbursement in the 70s, the politicians of today continue to bleed the hospitals of needed federal dollars.

As our borders were easily breached by “illegal aliens” (as we called them back then) who landed in our county hospital emergency rooms when they needed life-saving care, they continue to use them as a provider of last resort. The “federales” have jurisdiction over the national borders; thus the federal government, in my opinion, should reimburse the counties for providing free care to those non-insured immigrants.

Did I mention uncompensated care given to millions of Americans without health insurance? Under federal law, public hospitals cannot “dump” ( i.e., those without insurance) or “cheery-pick” ( those that are covered by a third-party) patients — they must accept and treat all persons who are brought to the emergency room. Who pays for the care that is uncompensated?

Local taxpayers pick-up the tab for that uncompensated care (in some cases, hospitals charge more to those with insurance to make up some of the difference). Yet public hospitals are still operating in the red, as the article stated.

Our local leaders are in a huge bind. Something must be done. What? I have some ideas but I’m not elected or appointed to the hospital board.

These folks must make the hard choices. Good luck to all of them.

Michael K. Gemmell

Natchez resident