Here are more letters regarding the health-care reform debate. Some of these are still under consideration for print. Find other letters on tomorrow's Other Opinion page.
Small business thrives on a small group of people who are willing to unite and devote efforts to a job that most people never understand. Similarly, it appears that the only headlines in the paper are about those very vocal opponents of the concept that everyone should be able to access affordable health care. We can all unite to solve the access problem and the cost problem. Innovation in delivering and maintaining health care is our challenge. One must ask onself if the benefits of providing access to healthcare outweighs a future without such humanitarian access.
After reading about Reps. Miller, Price and Etheridge, I am a little upset to see that they have already decided that we need health care reform that it appears a lot of people do not want. I thought we voted for people to represent what we want, not to force their opinions on us.
Somehow it does not make sense to scrap a private enterprise, which I am sure we all agree needs some work, and give it to a government that has driven Medicare to insolvency by 2017, and Social Security at best by 2039. Perhaps they need to fix these programs before creating the same problem with health care.
Why not remove the waste from the current system? I am sorry but a government takeover, call it socialism or whatever, is a bad idea. There is already too much government control of our lives. The other interesting point is by taking the excess costs out of health care and increasing competition we can lower the cost, and we do not need to bury future generations in debt.
The silver lining here is that there is an election coming in 15 months and it appears there are going to be a large number of congressmen that will be looking for employment in the private sector.
In the midst of our heath care debates, there seems to be some misconceptions about which country is the best. For comparison purposes, listed below are various indices for four representative countries: France for Europe, Canada as our northern neighbor and often mentioned in debates about single payer plan or universal health care, United Kingdom likewise often voiced to compare to the USA system, and the USA. These finding are from the the World Health Organization’s ranking of the country health systems. These might give us more information about heath care comparisons. For other countries go to the URLs.
Overall ranking of health care
France = 1st
UK = 18th
Canada = 30th
USA = 37th
Healthy Life Expectancy By Country
France = 3
UK = 14
Canada = 12
USA = 24
Life expectancy at birth total (years) 2008 Country Ranks
France = 8 [80.59 years]
UK = 33 [78.70]
Canada = 11 [80.34]
USA = 41 [78.00]
Health Performance Rank By Country
France = 4
UK = 24
Canada = 35
USA = 72
Total Expenditure on Health as % of GDP 2000-2005 Ranking
France = 10
UK = 41
Canada = 18
USA = 2
Infant mortality rate total (deaths/1,000 live births) 2008 Country Ranks
France = 209 [3.41/100,000]
UK = 196 [5.01]
Canada = 192 [4.63]
USA = 174 [6.37]
What a shame at a time like this when health care should be being debated by both sides that our congressmen aren’t having town meetings because of fear of disruption by opponents and then Nancy Pelosi calls the protestors un-American. Boy, that sure fixes the problem.
No one will ever change someone’s mind on health care by drowning out what the opponents have to say.
Letter to both sides: Sit down with each other and listen.
The number of uninsured in America is stated to be 47 million. This includes 12.5 million illegals who right now are costing American citizens $11 billion a year. It also includes people who can afford insurance but decide not pay for it.
The remaining Americans who have lost their jobs, insurance coverage and or have a very limited income can apply for Medicaid. There are, of course, certain restrictions depending on your net worth and income from other sources like interest and dividends. There is also nonprofit health care clinics that treat people who need outpatient care. Somewhere care, though minimal, can be found.
One other thing should be calculated in this debate. We now have a shortage of primary care doctors. How can including 47 million more patients not increase the deficit and restrictions on care?
President Obama wants a single payer health care plan and just expressed this view on TV while being interviewed by a AFLCIO official. His almost exact words were it may take 10 years or more but eventually private health insurance will disappear.
Albert F. Rodrick
During the discussions now occurring on the proposed changes in our health plans, it has been said that, “We in the United States have the best health care system in the world and it should not be changed just to satisfy some politicians!” Or words to that effect. That, by the way, is not a unanimous view. The World Health Organization ranks the United States as 37th out of 190 nations, behind such countries as Iceland, Canada and Colombia, where the cocaine comes from.
And our problems don’t start and stop with the delivery of care. There is a delayed action that can be ruinous to patient and families. Sixty-two percent of all bankruptcies in 2007 were linked to medical expenses. Of those filing for bankruptcy that year ,nearly 80% had health insurance! Just imagine the financial and psychological pressures on a family with a patient struggling with a serious — perhaps terminal — illness being subjected to calls from bill collectors and threats of court proceedings.
How could this happen? I can relate the events that transpired in my family as one way that our health care system can turn against patients and families.
In October 2000, my wife, Rebecca, was diagnosed during a routine checkup at the Mayo Clinic in Jacksonville, Fla., with non-small cell cancer of the lung. As she was a nonsmoker, this was completely unexpected. Physicians recommended surgery followed by chemotherapy and radiation. With over 40 years years in health care at that time, I realized that this would be a substantial expense. Knowing of the potential for our health plan to reject payment, I decided that a phone call to the plan would be prudent.
I called the plan administrator and spoke to the medical director, a physician and explained our location and situation. I asked if prior approval or a second opinion were necessary and was told that neither was required. We were on the State Employees Health Plan, generally considered to be very good. It even had a statement in the Benefits Brochure that the beneficiaries maximum out of pocket annual expense would be $1,500.
The surgery proceeded, and we learned that the cancer had entered the lymphatic system — not good news. Chemotherapy and radiation followed, which was very debilitating to Rebecca. Months after surgery, we arrived back home exhausted to the point where Rebecca needed a blood transfusion.
Five days later the bill arrived for diagnosis, tests, treatments and surgery. After the health plan payments, the bottom line was that we owed over $46,000, with payment in full due in 10 days ! Mayo refused to negotiate on the final bill.
What we didn’t know and were not told was that the hospital, physicians and clinic were not in the plan-approved network of providers. Everyone else — doctors, hospital, the clinic, the claim processor Blue Cross and the Health Plan — were all aware of this. Only we were excluded.
We could have taken the matter to court, but legal fees would have been at least $25,000 with no assurance that we would prevail. It would have been a gamble that could have increased our financial peril.
We avoided bankruptcy, but this is just one example of why our health care system needs attention. Pre-existing conditions are not the only tool for denying payment even after the procedures were approved by the Plan’s Medical Director !
Rebecca died in August 2006, more than five years after diagnosis so she counts as a technical survivor. I do not need any more evidence for a decision on the quality of our health care system.
Executive Director Emeritus of the N.C. Board of Pharmacy
To accomplish health insurance for virtually all of our nation's population, we need to curb the escalating cost of health care. To do so through incentives rather than governmental restrictions, we need more economic participation by the patients in health care expenditures. We could have a small co-pay for patients using measures beyond primary care. A three-tiered sliding scale could be developed with the co-pay ranging from 1 percent to 10 percent. This co-pay would apply to imaging procedures, hospitalizations, surgical procedures, chemotherapy and other measures.
This approach could be applied to all payment systems including Medicare, Medicaid and private insurance. The extent of coverage by supplemental insurance would be limited so that the patient makes the co-pay out of pocket.
This would force the patient to be concerned with the costs of care that goes beyond primary care. Such patient responsibilities would provoke discussions between doctors and patients regarding costs, might help motivate patients to healthier lifestyles and would sometimes stimulate less expensive avenues for serving medical needs.
This approach seems much more compatible with American individualism, which resents limitations imposed by an insurance company or a public agency. It would lead to a shift away from the entitlement mentality that contributes to increasing health care costs.
Robert H. Bilbro, M.D., FACP
Regarding the story “Democrats avoid health forums,” I find the actions of those responsible for bullying our senators, representatives and fellow constituents abhorrent. Having been on the receiving end of these tactics, I can say that, without any doubt, they are frightening as they are intended to be.
At noon on July 9, I along with 45 or 50 others in favor of health care reform met in front of the Sanford Federal Building in which Sen. Kay Hagan has her offices. We were joined by a number of opposition protesters who started yelling and chanting with their only purpose that of drowning out our speakers. They surrounded us and became verbally and physically threatening.
It is incumbent upon all Americans to resist the evil represented by this descent into violence and threats. We must corporately and individually exercise our own rights of free speech and communicate with our elected officials at all levels to denounce these tactics of intimidation. We must all speak out loudly on the issues that concern us. The press must investigate and shed light upon those responsible for this.
Most of all, we should not allow ourselves to be intimidated by these modern-day brownshirts.
If you boil down the health care debate to its bare bones, what you have is class warfare at its finest. Those with health care (including the stably employed) are arguing on the side of insurance companies for no change. Those without health care (including the poor and the recently unemployed) are arguing to transform the system.
Conservatives have always criticized liberals for engaging in class warfare. And let's face it, some of that criticism is warranted. But I never thought I would live to see the day when conservatives would so shamelessly pit classes against each other. Much of the health care debate is engineered as a means to create a rallying point for conservatives. Democrats did the same with the war when Bush was president.
But that wasn't about class. This case is one in which conservatives have drawn a clear line in the sand asking everyone to take a side. General Sherman once remarked about class saying, in our country … one class of men makes war and leaves another to fight it out. Whether we will be a better nation because of this fight remains to be seen.
Once again, I don't know whether to laugh, cry or double my Valium. The Page 1 photo Aug. 8 of people protesting President Obama's effort to offer an optional government health plan alternative to private for-profit plans boggled my mind!
Fact is, everyone 65 and older is already on the popular, effective Medicare program, which, horrors, is government administered. If you want to see a real massive outburst, just try to cancel Medicare.
I have found this government program (and Social Security and the VA) to offer excellent efficient service. But I have been on Medicare only 21 years!
How many times must the president say that his plan is totally optional? Therefore, if you are happy with your private plan, stay put. If you are unhappy or uninsured, you would have another program to consider.
Please keep my Medicare program until you read my obituary. Meanwhile, I'll relax watching malcontents stirring the misinformation pot. At the same time, also watching with great glee and total amazement, high in their penthouse offices, are mega-paid executives of the monopoly for-profit private health insurance companies.
As the Russian comic Smirnoff once said, “What a country!”
Ray W. Deltz Sr.
All of us in North Carolina, Democrat or Republican, need health care insurance with a strong public option. For those of us on Medicare, we already know what peace of mind this insurance brings us. We can also have supplemental insurance if we choose.
Already the cost of health care is causing people to lose their homes, it is bankrupting small businesses and it is causing great stress on hospitals that ultimately take care of those without coverage — that is, if the people don't die untreated and unknown.
This is not a question of Democrats or Republicans; it is a question of life or death for people; it is a question of the recovery of our economy.
A vote for health care reform with a strong public option is a vote for the health of this country and for all of us, Republican, Democrat or other.
The July 23 Point of View article by Dr. Valerie Jewells ("Counterproductive savings on medical imaging") at best misses the point of what most folks need in health care, and at worst represents the type of special interest that has stymied health care reform for four decades.
Sure, imaging has improved diagnostic capabilities for some diseases. But multiple studies have shown imaging is one of the top drivers of ever-increasing costs. The United States has more MRI, PET and CT scanners than any country on earth, yet the quality of our health is ranked 37th by the World Health Organization, and we spend thousands more per person on health than any country on earth. Recently, a count of scanners found more in Wake County than in Canada.
Jewells suggests that implementing radiology benefit management (RBM) would hamper patient care and result in intolerable waits. Funny, but there seems to be no lack of good health among Canadians, Brits and the French due to fewer scanners per capita.
Usually a careful history and physical exam will determine the diagnosis and any need for scanning.
Watchful waiting and selective treatment often leads to condition improvement.
Robert Harris, M.D.
Your article Aug. 8 about U.S. Rep. Bob Etheridge's health care meeting was very misleading. It said there were no protests and just universal support. That isn't surprising considering he met with the Johnston County Democratic Men's Club.
Etheridge is not planning any town hall meetings because he doesn't want to face people who disagree with him. He wants to paint a picture of universal acceptance of socialized medicine. This is not representation when you meet with only those constituents who agree with you.
If the good congressman can't handle the heat, maybe it is time for him to go.
It's nice that people rich enough to afford their own health care have a cause to rally around. Also nice that they have a newspaper to give them a hefty portion of the front page Aug. 8. It's sort of like one of those infomercials that resemble actual news.
I was shocked to see the photos and read the article Aug. 8 about the protest against the president's attempt to reform health care. I am not wealthy, and I am working as a “temp,” but I am more than happy to share the burden of health care costs for those who are less fortunate than me.
I know what it is like to live in poverty, although I no longer do. I know what it's like to have that gut fear that you are “going to get sick.”
We are already paying for care by way of higher costs. After all, does anyone really think that hospitals are not redistributing the wealth via “paying customers”? Doesn't anyone notice that their health premiums are skyrocketing?
I, for one, am ready to step up and help pay for health care for all, especially the most unfortunate. I'll manage. They, on the other hand, will not.
Sympathies to Brad Miller for the unwarranted disruption to his town hall meeting by ill-informed demonstrators. More sympathies to them, because they do not understand President Obama's plan or House and Senate plans in many fundamental ways.
Those who oppose a “government plan” should: relinquish Medicare (or encourage parents to do that); advocate that veterans, already in the system and those who will eventually return, not use the V.A. system; throw more than half of American children off Medicaid and S-CHIP; and pay for their own nursing home or assisted living care (i.e., give up Medicaid). Admit that nothing about the president's plan changes what they have now if they are satisfied with it. Agree to pay out-of-pocket for unnecessary tests and procedures, certainly when no evidence of effectiveness exists.
Health care/insurance reforms are long overdue; sensible alternative ideas are welcome; not hysteria, not lies. Otherwise costs will spiral upward; more people (especially in small businesses) will lose coverage. American industry will be even more uncompetitive globally. If demonstrations are not about health care reform, however, then we all need to pray for the safety of elected officials and the nation as a whole.
Our three Triangle congressmen aren't willing to listen to their constituents on health care. So far, President Obama's health care reform seems a scheme written mainly in secret and rushed through by the Democratic Congress and the White House.
The three cowardly congressmen are cowering from their constituents, in evading town hall meetings during their monthlong vacation. As reported, the congressmen's only planned meeting on health care was with an “invited” audience. Anyone with even the slightest reservation about Obama-care is being labeled part of a GOP mob. Whatever happened to our free speech tradition?
Even more dangerous, the White House is asking supporters to report Web postings or e-mails that seem “fishy” to an official e-mail address: firstname.lastname@example.org. Under Nixon we had the “Enemies List.” Now under Obama we have an even more wide-ranging “Enemies Database.”
So much for progress. Where is the ACLU when we need it?
Yes, I have a copy of the Health Care Reform Bill. No, I have not read all of its 1,088 pages, but I have read enough to know that it has glaring defects. Here are some observations:
The bill does not address the issue of tort reform. The burden of malpractice insurance drives the cost of medical care into the stratosphere, now exceeding 17 percent of gross domestic product (GDP) and headed for 25 percent. Practicing defensive medicine and ordering unnecessary tests, all generated by fear of malpractice lawsuits, are an abomination. It is wasteful, foolish and unwelcome.
Another issue that is not addressed in the bill is equality. Our Congress, like the rules recorded in the book “Animal Farm,” asserts that some pigs are more equal than other pigs. Why shouldn't all citizens enjoy the same health coverage that is afforded to the president, the Congress and the federal government employees?
Assad Meymandi, M.D., Ph.D.
In the past weeks, angry people have been showing up at town hall meetings with our congressional representatives. Even here in North Carolina, Rep. Brad Miller recently received a death threat because of his expected vote for health care reform.
Many of these allegedly spontaneous outbursts from average residents are part of a fake grassroots campaign run by big interests such as Americans for Prosperity. Other leaders of organizations fueling these protests are former field directors for George W. Bush, former DOW Chemical engineers and the leaders of big lobbyist groups.
I have no doubt that many people are legitimately concerned, even angry, about health care reform. And it is healthy to have a debate in which both sides have a chance to speak. But these crowds are being led by the same people who have always voted in favor of corporate interests and against working families.
I say give real reform a chance. The American people need to take back the debate with civility and a desire to move forward with reform. Because if we don't, we may lose our biggest opportunity to fix a badly broken system.
The reaction of Democratic leaders toward those who oppose having socialized medicine rammed down their throats is very telling. Any person expressing an opinion contrary to the plans of the Democratic Party is belittled or demonized.
It is obvious that Democrats are angered when their actions or motives are questioned by average Joe American citizens. Given the Democrats' feelings of superiority, I suppose it is only natural for them to resent back talk from people they consider too stupid to think for themselves.
In defense of the Democrats, I guess they did not expect such a negative response to their plans. After all, the American people did put them firmly in control of our government.
We can only hope that there will be enough civil freedom left in 3.5 years to vote them out. But I suspect the Democrats are already planning for this. They will soon make up excuses to limit free speech and assembly and to disarm the populace at large. From their standpoint, we are little more than sheep that need a shepherd. They will do whatever it takes to herd us in the direction they have already chosen.
I've been an R.N. for almost three decades. I've practiced in large teaching hospitals, private surgical practices and public health. There are differences, but a theme unique to America emerges: Financial and family devastation too often follow the diagnosis of a severe illness or a catastrophic accident. The status quo is unacceptable, and if unreformed will bring this great country down.
I wonder what exactly these people are protesting. Are they satisfied with the way things are? Do they realize that they might be a pre-existing condition or a Cobra payment away from losing their own coverage? From facing bankruptcy? Do they know that daily 14,000 Americans lose their coverage?
I am outraged that these mobs are sabotaging my right to meet with my representative, who recently received a direct threat. I want, and we need, a reasoned debate about how we can improve our very flawed health care delivery system to benefit us all.
Celia P. Liebl, R.N.
I support the protesters' right to voice opposition to health care reform. However, I am dismayed at the misinformation fueling these protests.
First, under the proposed bill, individuals may keep their current insurance providers. A public plan lets people opt for government insurance coverage. If you can afford, and want, Cadillac insurance, you'll be able to buy it.
Second, there are no “death panels” forcing elderly Medicare patients to choose the way they die or euthanizing disabled babies. Optional counseling helps people make decisions before they are incapable of doing so. As someone with an elderly uncle in the end-stages of cancer, it's comforting to understand his wishes and to be able to accommodate him.
Third, the fear of rationed health care under the reform plan is a red herring. Health care rationing is already going on. Through incentive programs, insurance company employees are financially motivated to limit coverage. What's better: decision-making based on what's best for the patient or what's best for the bottom line?
The proposed bill is a major step in the right direction. Others may disagree, but they should get their facts straight to be taken seriously. Perhaps they should offer alternatives rather than scare tactics.