More! More! More health-care letters

Nearly 20 more letters on health-care reform:

For the proponents of a public-choice option in the health-care debate (of which Medicare has been used as an example of public choice), my question is, what guarantee do we have that by enacting this hugely expensive government program we receive medical care? Couldn’t doctors and hospitals refuse to provide services to holders of this new type of insurance (as they are doing to Medicare recipients)? So, this leaves us with an expensive bureaucracy, but little in the way of new coverage. Maybe, we should break the this monster cookie up into smaller bites and concentrate first on limiting the skyrocketing costs of medical care, before we tackle health insurance for all.

Here’s an idea to lower costs (and possibly increase quality health care at the same time): Broaden the schools of those who can provide inexpensive primary care. Certain types of Physician Assistants and Nurse Practitioners can provide 90 percent of the needs for primary care (to include writing most prescriptions), at a fraction of the time and cost of putting one doctor through medical school and residency. Why limit these people?

Maybe our society would be better off with more routine access to PAs and NPs. Maybe, just maybe, we could redirect government financial aid away from law schools to these types of schools and programs. I’d rather live in a society with my PAs and NPs than lawyers. And, as cost savings kick in, that money could be redirected into insurance reform.

Bryan Andersen
Raleigh

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I was asked by someone whether I supported the new health-care reform as a Democrat. I answered, “I oppose the current Health Care option the administration is proposing.” His response, “You don’t believe in Social Security, Medicare or Medicaid? Then you should go through life without Medicare and Social Security since you don't believe in a government run system."

He turned and asked a woman who is Republican the same question. She obviously opposed it, claiming it had death panels. He responded calling her ignorant and misinformed by corrupt right-wing corporations.

He never asked her reason or as to why she believed it. He didn't allow me to answer whether I believed in government programs. Sounded much like a town hall debate. Except I might be the only Democrat in America who believes she has a valid point.

The insurance jargon in the policy leads one to think of it as “death panels.” However, instead of rewriting the policy so it is not misinterpreted, we call them idiots plagued by right-wing propaganda.

We lack leadership. Obama is a great leader. Why is he having so many problems with many of his policies? He is surrounded by politicians who are at war against the opposing party versus helping the people. We need true leadership and to part ways with the immature negative officials and journalists.

RC Steadham
Raleigh

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I think we can easily reform health care without creating a one-payer or a socialized health-care system.

For example, one option would be to grant the uninsured access to co-ops across state lines. If you lose your job or have pre-existing conditions, you can have insurance access through the co-op. Another example is to cut health-care costs by giving incentives for well being such as non smokers, exercise programs, etc.

I am also outraged by Obama, Pelosi and Reid trying to censor our opposition to socialized medicine. We should start by removing anyone from office (Nancy Pelosi) who calls us un-American because we disagree with a 1,000+ page bill outlining a socialized government-run system. Obama is desperately trying to silence his critics. He even set up a data collection site under the guise of misinformation so we can squeal on our neighbors who disagree with socialized health care. I would certainly call that un-American, if not something worse.

We have many other options to try first before we experiment with a government-run socialized health-care system. As one of many against the single-payer system, I say, hands off my health care.

Ed Meilus
Raleigh

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It seems to be the debate over health-care reform can be terminated with a simple amendment to the current Medicare program. I don’t think new legislation is needed at all.

I suggest that any citizen under 65 who chooses should be allowed to sign up for Medicare benefits paying a monthly premium based on reported income. The higher the income, the higher the premium. Additionally, any unemployed person should be entitled to automatic Medicare coverage.

These changes would satisfy the proponents of a public option for health care and alleviate the worries of opponents of a public option by not introducing any new programs. And everyone in the US would have access to health care.

Mark Eckert
Durham

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In your Aug. 23 editorial “Stay strong,” you said President Obama had called for and tried to build bipartisanship on health-care reform. He did call for a bipartisan approach on the campaign trail, that is true. But can you give specifics of meetings he has hosted with members of Congress from both sides of the aisle? Is there other evidence of a genuine effort? I can’t recall any. I recall an express train driven by the Democrats that almost came to a vote in Congress before the summer recess and before alternative voices were heard. Those voices have told us (sometimes too loudly) that they are concerned about losing the health-care protection they have.

We know Obama knows how to call a meeting. He very effectively invited Dr. Gates and Sgt. Crowley over for a beer to get that story off the front page after he himself unnecessarily inflamed that unfortunate situation. So why not meet with Republicans? That couldn’t be worse that the “extended hand” he was going to offer to Iran’s Supreme Leader Ayatollah Ali Khamenei or President Mahmoud Ahmadinejad. Or, was that more campaign rhetoric?

We know that since 2003 Obama has envisioned a single-payer system for health care. He has acknowledged that such a system will need to be introduced incrementally. A public  “option” is one approach to doing that. Eventually the public option becomes universal and private insurers are relegated to a supplemental insurance coverage role. Thus will be born another huge government bureaucracy.

Please remember that a few years ago Congress was to “fix” Social Security before the  “Trust Fund” was exhausted. Never happened. By the way, there is no trust fund, just a huge filing cabinet with projected IOUs. The government matches receipts and payments. Projections indicate payments will begin to exceed receipts  — but heck, that’s several years away.

For guidance, look to George Will’s column on Aug. 23 “Butting out of business.” See how partisan politics work both ways. Will’s point is as applicable to health care as it is to the business world.

Let the voices be heard. Let’s open a real dialogue on how to approach this very complicated matter. Let’s keep the voices positive and respectful. Let’s not push reform with Obama’s Democratic majorities in Congress as you suggest if it’s at the expense of the American people.

Ed McCarthy
Raleigh

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I am not surprised at the abundance of ignorance re health care. Most Americans do not know their own history much less that of others. The health-care systems of all the other countries work remarkably well, and since these protesters have not done their homework, it is obvious that they have no knowledge of how much better these systems are than ours.

We rank 37 in morbidity/mortality — you should look that up if you do not understand it — all the other countries have much healthier people than we do, and if you don’t think your insurance company will rake you over the coals, just wait.

I did insurance billing for quite a while, and they work for themselves, not for patients. I would like to see these people do their homework and find out for themselves what the truth is and not rely on the Rush Limbaughs of this world.

Sarah Keith
Fuquay-Varina

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The People's Forum has included letters expressing the following opinions:

“The Public Option is a bad idea because Medicare is going broke.” The physician writing this opinion fails to note that the reason for Medicare’s fiscal difficulty is not bureaucratic issues such as administrative costs, which are many times less than for private insurance coverage; it’s due to funding insufficiency. Unlike the Republicans’ Medicare Part D —which contributes to the public debt burden upon future generations — the Democrats’ proposal intends to be cost-neutral.

“The Democrats made no attempt to include Republicans in drafting health-care legislation.” The Republicans have had every opportunity to join in negotiations but have set in stone that there will be no public option. This provision is a compromise allowing private insurance to compete as opposed to going with the most cost effective solution: single payer.  

“The majority of the people oppose the president's plan and how he has handled health-care reform.” The public supports the key outlines of his program. Had he presented a finished product for consideration, the same critics would have said that it would have been the unpopular Clinton approach all over again.

As far as “what happened to representative government,” the Democrats have been elected as the majority party of the Senate and of the House. Representative government continues a downhill slide, however, in as much as the Republicans and their water carriers continue to promote extensive misinformation regarding the Democrats’ health-care proposals.

“Refusal to consider a cap on damage awards from medical treatment.”  I agree that there should be compromise on this.

Just as Newt Gingrich blocked any reform from passing in the early 1990s in order to keep the Democrats from scoring a victory, the 2009 “party of no” is using the same strategy, regardless of the consequences for the country’s citizens.

Mike Massey
Durham

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Rep. Maxine Waters recently called the Democratic senators who do not support President Obama’s health care plan “Neanderthals.”  This is an example of the arrogant attitude that is making Americans angry in town hall meetings everywhere.

Why angry? Because those senators represent constituents. And according to recent Gallup poll data, 36% of Americans who have an opinion about the president's health care plan oppose it, while only 35% support it.

On the health-care issue, President Obama is trying to lead the country in a direction it does not want to go. Our leaders are not listening. Rest assured, Americans are watching

John Brewer
Clayton

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Let's try a little bit of Republican logic for the health care bill. I was looking through the health care bill (HR 3200) and noticed these horrible parts of this government power grab!  Check it out for yourself, it’s all in there. It says "death" "panel" "will" "cause" "premature" "death" "for" "all" "without" "exception" "including children, adolescents, adults, and seniors".

And I can document every little bit of it!  "death" is on page 596; "panel" is on page 513; "will" is on page 475; "cause" is on page 163; "premature" is on page 971; "death" is on page 588; "for" is page 968; "all" is on page 913; "without" is on page 423; "exception" is on page 218 and "including children, adolescents, adults, and seniors" is on page 519.  

So there you go! It’s unequivocal that health-care reform means death for everyone!  

Ok, now it’s time to leave delusional world and come back to reality. If you oppose health-care reform, then have the guts to just say you're against it because of your ideology. There's nothing wrong with that. But don't be a coward and hide behind lies!

Wake up, folks! Support robust health care reform now! Support Medicare for all! And if you can't do that, then support a robust public option! Stand up for what you believe in because the other side is surely trying to stomp out your views at all costs!

Brian Baer
Apex

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The Democrats had better wake up, and the Republicans had better pay close attention. The uproar you are hearing is not just about health care, that is just the last straw.  We are mad and frightened about the whole trend we have seen since Democrats gained control of both houses of Congress two years ago and the White house this year.

The trend I am talking about is government taking control of everything in sight; the government took control of the largest car company in the world, it took control of insurance companies, telling them whom they could have as their CEO and how much they can pay them; it’s done the same with banks, and now it wants to control the health industry.

If you think you will get to keep your current insurance company, ask anyone over 65 who was forced to give up a private insurer and go on Medicare only to see coverage decrease. If you aren't frightened, then you don't know what is happening around you.

Dick VanCleave
Fuquay-Varina

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As I watched the news Aug. 25, a newscaster stated that with the deficit expanding at an ever increasing rate, there would undoubtedly have to be severe cutbacks to entitlement programs such as Social Security and Medicare.

Feel free to correct me if I’m wrong, but haven’t I and millions of other employed persons been paying into this system for many years? I have been paying into these systems since I was 13 years old. I have been employed productively all the years of my adult life, and now all of the sudden I am told that I need to realize that I may have to have my benefits cut or done away with entirely because of the budget situation in the United States.

Don’t get me wrong, I do not wish to see anyone go without clothing, food, shelter or health care. It just seems somehow unjust that millions of persons, some of questionable citizenship, can receive benefits from these and other programs without having contributed a dime into any of the systems.

Recently the members of Congress have helped the financial institutions and the car manufacturers and are planning to help all of us with Free public option health insurance.  I can deduce from what I have seen as a result of past help of this type that I don’t want any more help. I don’t remember exactly when we as a nation transferred our moral obligations to our government, but it would seem to have been a very bad idea.

In the past people looked after each other’s interests. Now it would seem that we want the government to do it for everyone. The trouble with this train of thought is eventually you run out of other people’s money. When do you suppose this country will awaken from its apathy? Do what is right now or forever regret it.

Stephen C. Trexler
Raleigh

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I've been receiving forwarded e-mails from some of my more conservative friends in reference to, among other things, President Obama being compared to Hitler, Socialist leanings, articles purporting to confirm that the president is not an American citizen, etc.

As a lifelong Independent voter who used to lean to the political right, I find myself getting ready to declare myself a Democrat.  

What seems to be coming from the extremist right and appears to be  rom the teachings of the Karl Rove/Dick Cheney school of misinformation, fabrication and dirty tricks is being circulated via the Internet.

I can certainly understand, and expect a dialogue of the differences in opinion(s) of the two major parties in all the important issues. But I haven't seen very much dialogue coming from the right, other than fabrications, distortions, out of context quotations and mis-directions.  

If the GOP wants my vote in the future, I'm going to have to see more honest debate and less nonsense injected into the information super highway that purports to be the "truth".

Fred Krenrich
Cary
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Millions of our citizens do not receive adequate health care simply because they can’t afford it.  We are the only wealthy country in the world that does not guarantee essential health care for everyone.  

An estimated 28 million Americans have no health insurance, and 24 million have inadequate insurance with high deductibles and uncovered expenses. Many postpone needed treatment or go into debt to pay medical bills. Uninsured and underinsured people are more likely to die prematurely.

The U.S. has the most expensive health care system in the world, yet our infant mortality rate is on a par with that of many Third World countries.  

Insurance and pharmaceutical companies spend millions of dollars every month lobbying (i.e. buying) Congress to ensure their profits aren’t diminished by reform.

Some conservative groups spend money to spread lies that frighten the public (e.g. death panels). Their goal is to deliver a defeat to Obama for political reasons.   

Others say we’re moving too fast and increasing the deficit.  We’ve debated health-care reform for over 30 years!  And no one complained about deficits created by the Iraq war or tax cuts for the wealthy.

Linda Palmer
Asheville

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Yes we need to fix health care. Some suggest a government -run option to compete with private health insurers. It sounds simple, right? But if a public option pays like Medicare does, doctors and hospitals will be paid as little as 80 cents of every dollar of service they provide. That means they must recoup 20 percent from somewhere - guess who? It’s those with private health insurance.
Government underpayment is one reason why private health insurance is so expense. It’s a hidden Medicare-Medicaid tax that for an average family of four pays an estimated $1,500 more in insurance premiums per year. The math is simple — if more and more people jump onto an artificially cheaper public plan, fewer and fewer people will be able to afford private health insurance. Put another way, if more and more people underpay health care providers through a public plan, those left with private health insurance must make up the difference through escalating insurance premiums.

Soon even those who want to keep their private coverage will have no choice but to jump to the public plan. Does that sound like a level playing field?

Antonio "Tony" Gutierrez
Raleigh

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There is much confusion these days about the health-care reforms proposed death panels being created to expedite a persons death.  Let’s stop a moment and evaluate a couple of ways we can direct our own health care now.

Each person should take the time to complete or review his/her own advance directives, which are just that — directives made in advance of a crisis rendering one unable to express his/her medical wishes. You can document your medical and end-of-life treatment wishes by utilizing the health-care power of attorney and/or living will forms.  As important are discussions about your wishes with family, friends, physicians and others before a crisis.  

The documents and conversations will do much to reduce stress, confusion and anxiety later. Laws and government don’t need to tell us this.

Resources for advance directives are as close as your family attorney, the Internet (www.caringinfo.org), or the N.C. Secretary of State’s Office (sosnc.com). Locally, Life Decisions Coalition provides presentations on advance directives free of charge.  E-mail the Coalition at lifedecisions@bellsouth.net or call 919-828-0890 for more information.

Darcy Dye
Community and Public Relations Manager
Hospice of Wake County, Inc.

Sherry Harris
Director, Life Decisions Coalition of Wake County

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As the saying goes, there is no free lunch. If you want to add coverage for an additional 20% of the population, somebody has to give up something or pay more.

According to the centers for Medicare and Medicaid, the annual spending on health care is about $2.5 trillion (with a T). Knowing that the U.S. population is about 300 million, this $2.5 trillion is being spent on about 250 million people (since we are planning to provide insurance to an additional 50 million who are currently uninsured). This works out to be about $10,000 per person. The administration and the Congress is estimating that it will cost only about $100 billion per year ($1 trillion in 10 years) to cover these 50 million uninsured, which works out to be about $2,000 per person.  

If we are spending about $10,000 currently to cover one person, imagine what kind of coverage you will get for $2,000. This means either the Congress or the administration is vastly underestimating the cost to provide healthcare for the uninsured or they are fully aware that some services are going to be cut to accommodate the uninsured. Remember, the president keeps saying that if you like your current plan, you can keep it. Nobody will take it away. Again, there is no free lunch.  

Soma Sekar
Morrisville