Letters to the Editor

Write a Letter to the Editor

Letters to the Editor
Writing a letter to the editor of your local newspaper is one of the best ways to influence health care reform. Letters to the editor are an easy way to voice your opinion, draw attention to an issue, bring issues to the attention of your legislators, and correct or interpret facts in response to an inaccurate or biased article.

Submitting an effective letter

• Keep it short

• Use local statistics and personal stories

• Relate your letter to a recent article or op-ed

• Include your phone numbers and address, as the publication will need to confirm that you wrote the letter before they publish it.

Writing Op-Eds

• Opinion/editorials are longer than letters to the editor (between 500 and 800 words.)

• Be newsworthy: Tie your topic into an upcoming vote, appropriate holiday, anniversary, community event, the release of a new report, a recent article, or a popular movie.

• Consider inviting a respected or influential member or your community to co-sign or co-author the Op-Ed with you.

• Use local statistics to capture people’s attention.

• It usually takes editorial boards two weeks to review submissions.

Influencing Editorials

Editorials endorsing a particular issue or piece of legislation can change even the most committed policy maker’s mind.

• Research the newspaper to discover if they already have written an editorial on the topic and to make sure that their editorials are locally written.
  
• Research your topic with an eye to arguements from other sides.

The following are examples of effective letters to the editor:

Letter to The Kansas City Star, Sun, Jan. 26, 2003
AS I SEE IT: Single-Payer System Would Fix Health System

By JOSHUA FREEMAN

The United States’ health system is in crisis. Despite spending at least twice as much per capita as any other country, we have 41 million uninsured people, another 30 million underinsured, and everyone watching costs go up and our access down. Expensive high-tech care is available to some, but even basic and preventive care is often unavailable to many. Our national health indicators rank with the best of the third-world countries rather than the industrialized democracies.

This inequitable and costly situation is increasingly unacceptable to most Americans, including physicians and health policy experts. Many proposals involve maintaining much of our expensive and inefficient system and throwing in more money to cover some additional people.

In Canada (the country whose social and economic structure is most similar to our own), a single payer, the government, pays the bills while people are free to choose among providers of medical services, most of them in private practice.

Everyone is covered, regardless of income, age, employment status, or pre-existing condition. No one loses insurance if they lose their job or exceed their deductible. Hospitals are funded by global budgets worked out on an annual basis. Administrative cost savings to doctors and hospitals are enormous.

Those who observe that there are waits for some elective services in Canada are confusing how health-care resources are distributed (inequitably in the United States, equitably in Canada) and how much we spend on health care. Per capita, the United States spends twice what Canada spends and four times what Britain spends; if either country could afford to spend anything close to these levels, there would be no waits for any services in either country. What we lack is a structure that is rational and equitable, as is single payer.

And cost? A single-payer system would dramatically reduce administrative costs. Canada’s system has a 1 percent overhead and the U.S. Medicare system overhead is less than 4 percent. These compare with the greater than 20 percent overhead of our biggest HMOs.

Overall, administrative costs in the United States, including all paperwork and billing, are about 30 percent of our health-care budget. Reducing it to Canadian levels would save enough money to cover our uninsured. More than half of our health dollars are already tax-supported (Medicare, Medicaid, government employees, military, tax breaks to providers, etc.), and the new taxes needed would be offset by decreased insurance premiums and out-of-pocket costs.

The American people can demand a rational cost-effective system that provides equitable, necessary access to health care for all. Eliminating insurance industry profit and implementing a single-payer system can be a central part of this solution.

Joshua Freeman is chairman of the department of family medicine at the University of Kansas Medical Center. His opinions are not necessarily those of the university or the hospital. He lives in Kansas City, Kan.

No Health Plan After 40 Years

The last paragraph of the May 30 editorial “Those Medicare Discount Cards” says it all: “The strongest military power and the richest nation has yet to agree on a way to protect all of its citizens [with national health care].”

This fall, we celebrate the 40th anniversary of the signing of the Medicare Act. For many of us, it was our hope to have a national health plan for all within the next three years.

Unfortunately, that has not happened and today, more than 44 million have no health insurance coverage. Beyond the 44 million are those who are underinsured, have lost their jobs and their insurance. Figuring those people in, the numbers rise closer to more than 80 million in any given month of the year.

It is never too late to pass a Health Security Act that would cover everyone from cradle to grave. Just the will of our citizens and a government that realizes that a healthy nation is dependent upon its government to provide comprehensive health coverage to all.

Tweaking of the law and in particular this new drug discount card is a sham. In the long run, more people will realize that a bad Medicare Act of 2003 was passed and demand it be rescinded.

Naomi E. Shaiken
President

Alfred Shaiken
Vice President
Connecticut Call To Action
New Haven

Letter to The Los Angeles Times
January 4, 2003
A Rational Health System

Re “Rx for Universal Care,” editorial, Dec. 29: Although every caring person agrees that the debate on universal care needs to be moved into the mainstream arena, considerable confusion remains. Should we build on the current system of employer-sponsored plans and public programs or should we replace them with a single-payer system?

Although continuing to use private plans would perpetuate the tremendous administrative excesses that waste resources that should be directed to patient care, fewer public tax dollars would be required to expand coverage to everyone. But most individuals and businesses should be concerned not only about their tax expenditures for health care; they should be concerned about their total health-care expenditures, both public and private. An increase in tax funding should not be objectionable when it is offset by an even greater reduction in private health-care spending.

In a universal system, rationing is determined primarily by the capacity of the system. A system that reduces administrative waste increases its capacity. We may be so averse to the words “tax” and “government rationing” that we may want to continue with a system that wastes more funds and results in greater rationing. But then again, maybe we’re ready to agree that rational policy should prevail over rhetoric.

Don McCanne MD President, Physicians for a National Health Program San Juan Capistrano

Letter to The Oregonian
December 2, 2002
Health-care reform post-Measure 23

Measure 23 (Health Care for All) died an ignominious death on Nov. 5, but the health care crisis is still with us. The Oregon Health Plan’s future is uncertain and nearly half a million Oregonians are uninsured, including many low-wage workers. Many more are underinsured and struggling to pay exorbitant premiums. On a national level, moderate Sen. John Breaux of Louisiana declares that U.S. health care is “collapsing around us”. The horror stories that volunteers for Measure 23 heard during the campaign are remembered. But where do we go from here?

Americans spend far more on health care than other developed countries. Yet, the U.S. ranks only thirty-seventh in quality, according to the World Health Organization. Employer-based health care greatly increases labor costs, holds down wages, and keeps employees tied to particular jobs. U.S. health care costs are distributed through premiums, employer benefits, out-of-pocket expenses, and TAXES, so that the full cost is not appreciated. Our taxes pay for 60 percent of U.S. health care, while the Canadian government pays for 70 percent of Canadian health care. We are paying for a national health care system, but not receiving it.

Congress seems committed to “incrementalism” - just covering children, the needy, prescription drugs for the elderly, etc. From a cost-control viewpoint alone, two things are wrong with our piecemeal approach. First, as long as the uninsured are increasing and not getting preventive care, rising costs will be shifted to the insured. Restricting health care has contributed to the double-digit inflation in health care premiums. In any insurance plan, the larger the risk pool, the smaller the cost for the individual. Therefore, cost-effective health care will start with universal coverage. Second, the huge administrative costs of the insurance companies must be eliminated. Health care as a public service does not fit a profit-driven system. Administrative costs of a single-payer (government-insured) health care system are typically one-fifth that of a U.S. insurance company. Additionally, a national plan (as opposed to state-wide) eases the burden on small states and eliminates the migration argument.

The General Accounting Office has determined that single-payer national health care is the most cost-effective method of health care delivery that maintains providers in the private sector. It is no stranger to the U.S. Medicare was originally conceived as a single-payer system but is presently filtered through many insurance companies, adding to the complexity, expense, and diminishing coverage.

While the benefits of national health insurance are clear, many obstacles stand in the way. Americans must be persuaded that under such a system, provider choice would expand, not diminish, and that quality need not be sacrificed. The feeling that government cannot properly administer any public service is an American conviction, in spite of the popularity of Social Security, Medicare, Medicaid, an excellent military, and the fact that over 90% of Americans are publicly educated.

Where does health care reform go from here? A simplified state-wide initiative might be attempted to keep the issue alive. More Americans must be registered to vote so that they can support reform-minded candidates. Support the Wyden-Hatch Act and other legislation that will be introduced in 2003. In the meantime, let’s keep talking.

(Roberta Palmer, M.D., of Tigard is a member of Physicians for a National Health Program.)

Letter to Physicians Money Digest

Your recent Editor’s Note, “Canada’s Doctors Heading South,” suggests to me it’s time to call a halt to bashing the Canadian health system. First, because the data cited is invariably misleading and often mendacious. Second, far more important, it takes attention away from our own health care catastrophe which is a national disgrace.

Your essay starts with a whopper, harbinger for the disinformation further down the line. We learn “that nation [Canada] of 59 million people” … you’re off by a magnitude: Canada has 31.5 million as of 2001.

Giving no hard numbers, we are told “doctors leaving the country jumped nearly 70% last year.” A recent report, September 25, 2002, by Rachlis and Evans, et. al., takes a serious look at the doctor drain question. “In fact, Canada now has more doctors than ever before—58,546 in 2001 and the per capita ratio has remained approximately the same for 10 years—now one doctor to every 532 Canadians, compared to one to 950 in the 1960s. Most recently, between 1997 and 2001, the number of physicians grew by 6%, considerably above the 3.7% growth in the Canadian population.”

“In 2001, 609 doctors left Canada, while 334 Canadian doctors returned, for a net loss of 275 or 0.5% of the physician work force. In addition, in 1997, almost 850 non-Canadian physicians entered Canada,” augmenting the continued growth of physician to population ratio.

The fiction that Canadians in significant numbers cross the border to the US for care is analyzed in depth in the May/June 2002 Health Affairs. The headline is “Phantoms In The Snow: Canadians’ Use Of Health Care Services In The United States; Surprisingly few Canadians travel to the United States for health care, despite the persistence of the myth.” For example, “several sources of evidence from Canada reinforce the notion that Canadians seeking care in the United States were relatively rare during the study period. Only 90 of the 18,000 respondents to the 1996 Canadian National Population Health Survey indicated that they had received health care in the United States during the previous twelve months, and only twenty indicated they had gone to the United States expressly for the purpose of getting that care.”

The authors ask, “Why is cross-border care seeking so low? Our results should probably not, on reflection, be surprising. Prices for US health care services are extraordinarily high, compared with those in all other countries, and this financial barrier is magnified by the extraordinary strength of the US dollar. Private insurance for elective services, being subject to very strong adverse selection, is, not surprisingly, nonexistent.”

The authors conclude, “debates over health policy furnish a number of examples of these zombies’— ideas that, on logic or evidence are intellectually dead—that can never be laid to rest, because they are useful to some powerful interest. The phantom hordes of medical refugees are likely to remain among them.”

On November 28, former Saskatchewan Premier Roy Romanow, released his report on Canada’s health system, based on an 18-month study by his commission. This historic document concludes that the system is extremely popular and basically sound. It is, predictably, in need of improvement, notably more funding (bear in mind that Canada has a system of universal coverage, expending $2,000 per capita, compared to US $5,000 per capita with over 40 million uninsured). Romanow calls for restoration of the federal contribution to the provincial health systems. There are other constructive recommendations, notably marked increase in attention to prevention, expansion of high-tech capability, coverage of pharmaceuticals, and development of more professional teams to serve the people of Canada. While this report will be vigorously debated, it appears to be the blueprint for the next phase of Canada’s magnificent health system.

How long, I wonder, will it take for the United States, with our vastly superior resources—in dollars, workforce, and plant—to create our own, hopefully better version of a universal, single-payer health benefit for all our people?

Sincerely,
Quentin Young, MD
National Coordinator, Physicians for a National Health Program

From Letters to the Editor, The Tennessean (Nashville), 10/21/03
U.S. health-care system allows people to die

As Dr. Charles Eckstein (”We can do better than British and Canadians on health care”) advised in his Oct. 17 Nashville Eye column, I went to the American Medical Association’s Web site and reviewed its plan for health insurance reform. What I found there was a plan to ”induce most people to purchase health insurance” by providing tax credits.

To its credit, the AMA proposal does attempt to break the anachronistic link between employment and health insurance, but it leaves individuals to find their own way in a bewildering health insurance marketplace.

The AMA plan fatally assumes that people will choose to buy health insurance, whether they are employed or not, because the tax system will refund part or all of what they pay. The document recognizes the unfair burden of the current system on the poor, but it fails to recognize the depth of poverty and the irrelevance of the tax system to daily decisions about whether to pay for food, rent or medicine.

Dr. Eckstein pulls out the tired canard of ”socialized medicine,” saying Canadians are ”suffering and dying on waiting lists.” Sadly, the free-market arrangements that dominate health care in the U.S. have left Americans to suffer and die because they were uninsured and too poor to even get on the waiting lists. This is a moral outrage. We clearly must arrange our affairs so that health care is distributed equitably.

A straightforward way to health-care equity was proposed in August by 8,000 (not ”a few,” as Dr. Eckstein wrote) physicians. In the proposal, everyone pays according to his means through progressive taxation, everyone has the same insurance, and everyone has equal access to care.

It’s a second opinion that’s worth a look, at www.pnhp.org.

John Lozier

National Health Care for the Homeless Council

Nashville 37206

Letter to the editor of the Oregonian by a Portland Physician
12/30/03
Leigh C. Dolin

We have the best health care in the world! We don’t let big government tell us what to do, and we give maximum opportunity for individual initiative to prove itself. Isn’t it time to expand the lessons learned from providing health care to other basic services?

Let’s privatize police departments! Why should we let big government tell us how our laws should be enforced? From now on, police services will be run by competing private businesses. Competition will provide better and more efficient results, as we have proved in our health care system. Employers will include police benefits as part of their fringe benefits, with moderate deductibles to discourage workers from calling the police unnecessarily.

Police insurance companies will use the same principles that have been used so successfully in health care. They will target their marketing to those least in need of police services and actively discourage those covered from using police departments. As with health care, those who can afford additional coverage will be allowed to get it — the more they pay, the more they’ll get.

Basic coverage for the elderly and disabled will be available under “Protecticare,” a government-sponsored program. This will allow for police to be summoned for assaults in progress and to assist in murder investigations. For those individuals wanting help with lesser crimes such as burglaries and arson, this will be available for additional payments by private “Protectigap” insurance policies.

Of course, this new approach will leave a large group of citizens not covered by any of these programs. For these people, who have proved their inability to compete in our free-enterprise system, gun laws will be loosened so they can protect themselves as necessary. While this may necessitate their being relocated to restricted areas, so as not to endanger their neighbors who have adequate police insurance, this should not be an insurmountable problem.

We have the health care system we want, and we have repeatedly resisted efforts to change it. Let’s get started proving that other basic services can be provided in the same profitable way that we provide health care.

If we can make money delivering health care, why can’t we do the same providing police protection?

Dr. Leigh C. Dolin is a practicing internist in Portland and a former president of the Oregon Medical Association.

From: Sarah Kemble
Sent: Thursday, September 30, 2004 8:19 PM
To: letters@recorder.com
Subject: PNHP chapter formation

September 30, 2004

To the editor:

We could not agree more with your editorial reacting to the breakdown of our health care system (“A sick system,” Tuesday, September 14). Another recent op-ed piece by Ronald Brownstein (“A picture of stark contrasts,” Tuesday, September 21) elaborates in a helpful way on the problems. In the United States, we are spending far more for less care than any other society in history, with no end in sight as the trend accelerates. We therefore hope you will take the next logical step, and look forward to a Recorder endorsement of single payer health care financing in the near future.

Allowing the profit motive to control our health care system is a unique experiment here in the United States, and it has failed! Only by consolidating this important system (well over one-tenth of our national economy) under a single, publicly-responsive payer can we rescue Medicare and stop the hemorrhage of obscene profits, administrative waste and outright fraud by the largely-unregulated insurance and pharmaceutical corporations.

As doctors, we feel heartbroken to experience the destruction of our once great and generous health care system. Delivering expensive care to the uninsured population was always difficult, but used to be manageable as the problem involved small numbers of people, and charity care was an integral part of our culture. Now millions of working and retired middle class people join the ranks of the uninsured, as a once-affordable benefit of employment gets dropped from the cost of doing business. Even more disturbing, it is increasingly difficult to deliver needed care to our insured patients, as private insurance and Medicare premiums skyrocket, while coverage becomes stingier each year.

We now believe it’s part of our job as healers to come out publicly in the interests of our community’s health. This health care crisis can and must be addressed. We are pleased to announce that we are founding Franklin County Physicians for a National Health Program, a new local chapter of this respected national organization advocating for social justice and a single payer health care system. Your readers and our patients will be hearing more from us in the weeks and months to come! In the meantime, we hope that everyone seeking more information on this vital topic will visit the PNHP website at www.pnhp.org.

Sincerely,

Nancee Bershof, MD
Kathleen Kerr, MD
Jeff Dickey, MD
Dick McGinn, MD
Bert Fernandez, MD
Kat McGraw, MD
Merritt Garland, MD
Sandy Perkins, MD
Kathy Grandison, MD
Barry Poret, MD
Sarah Kemble, MD, MPH
Al Ross, MD
Flora Sadri, DO, MPH

Pull health care out of crisis mode

Outside America, most health care systems provide medications from one comprehensive formulary to all citizens. There are no restrictions or economic credentialing, and all citizens are included.

In addition, the rest of the world’s health care systems negotiate the prices of their drugs.

We seem to relish going from crisis to crisis. Many now face the economic decision of purchasing food or medications. There is, however, a solution.

The next time you hear the words “national health insurance” or “single-payer health care,” take note that this kind of system will cost less than our current system and cover all Americans with much less red tape.

Speaking of red, we are not talking about socialized medicine. It is American medicine for all Americans, by all Americans. For more information, visit www.pnhp.org/

Charles Katzenberg, M.D.
Physicians for a National Health Program, Tucson

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