Health Coverage in the Balance
The New York Times
Letters to the Editor
September 25, 2007
To the Editor:
Re “The Battle Over Health Care” (editorial, Sept. 23):
As long as we continue to build on our current fragmented system of financing health care through a multitude of private plans and public programs, we will never get a handle on rising health care costs.
The administrative efficiencies of a single national health insurance program would free up enough funds to pay for care for the uninsured and under-insured. But reducing administrative waste alone is not enough.
With our own national health program we could improve incentives that would reinforce our rapidly deteriorating primary care infrastructure. Providing everyone with access to a primary care medical home has been demonstrated to slow cost increases while improving quality.
Appropriate specialized high-tech services certainly provide value, but such care very often is overused, resulting in no benefit while driving up costs. A trusted primary care practitioner can provide each of us with advice on those services that actually would be of benefit.
Don McCanne, M.D.
Senior Health Policy Fellow
Physicians for a National Health Program
San Juan Capistrano, Calif.
Sept. 23, 2007
To the Editor:
It is amazing how the presidential candidates are determined to come up with health insurance programs that are invariably complicated, often tied to employers, and frequently based on taxation gimmicks. They seem to ignore the one insurance program that is overwhelmingly popular and already has infrastructure in place: Medicare.
It is a highly efficient program that confounds all the critics of government-run health care. There are no restrictions on choosing doctors, the medical providers do not work for the government, and the processing of insurance claims is virtually transparent to the consumer.
In fact, from a consumer standpoint, Medicare is the best health insurance program ever invented.
The easiest solution to the problem of health care coverage, without resorting to one of the half-baked schemes offered by the candidates, is to simply offer Medicare coverage to anyone who wants it.
Of course, indigent people would be given a break on premiums. Employers could still offer insurance coverage if they wish, as a way of attracting employees. And if an individual does not like Medicare coverage he can still go to the private market.
As for states enacting their own insurance plans, sure, go to it. But let’s also offer consumers another choice: voluntary Medicare. Then, the consumers themselves, not the politicians, can decide whether they want public or private health insurance.
Ron Sheppe
Rochester, N.H., Sept. 23, 2007
To the Editor:
Thank you for your excellent editorial focusing on the heath care “debate.” There is another major factor in the debate, however, that was largely absent from your editorial. Specifically, your discussion only briefly touched on excessive insurance company costs and profits.
You commented on the fact that all of the Democratic candidates are looking at a system of universal coverage provided by private insurance companies and government programs. While that is likely our current political reality, it does not negate the need to look far more closely at insurance companies.
The fact is that private insurance companies spend far more on administrative costs than their government counterparts. Further, the amount of profit that the insurance companies retain is often excessive. If the United States is going to provide care to an additional 47 million people, we cannot afford inefficient administrative systems and the payment of outrageous profits to insurance companies.
Ellen Schiff
Los Angeles, Sept. 23, 2007
To the Editor:
The Democratic candidates for president all have similar proposals, which are steps in the right direction, but as your editorial points out, they lack measures for cutting costs. The most effective way to cut costs is to adopt a single-payer system, which is now available as Medicare, and would cut administration costs in half.
Since that seems to be beyond the pale, it is doubtful that any realistic cost savings will occur. It is apparent that a reassessment and redefinition of hospital goals and practices is in order.
Hospitals should be cooperative institutions rather than competitive institutions. As long as hospitals are profit-seeking and competitive, all will need to be full-service hospitals, maintain significant advertising and public relations budgets, and continue the plethora of building and expansion programs. Like all profit-seeking corporations, they can’t afford to appear as second best.
Hospitals are not the only problem area. Medical schools, insurance companies, pharmaceutical corporations and physicians all contribute to the high cost of health care. As long as we continue the myth of health care as market-driven and profit-oriented, the costs will continue to increase. The Democrats should have enough backbone to do the right thing and endorse what we all know is best: a single-payer system.
Harry E. Berndt
Webster Groves, Mo., Sept. 23, 2007
To the Editor:
Your attempt to address “The Battle Over Health Care” is admirable, but your conclusions under the heading of “What’s Missing” are as timid as those of the political candidates. If we value the health of our citizens, then just as we provide basic fire protection and police protection, we should also provide basic medical protection.
We cannot morally countenance winners and losers in the free-market sense in health care, just as we cannot in security and fire protection. It’s time to drop the ridiculous phobia of the “single payer” system and set about designing the most efficient government-run program we can, caring for the greatest number of people without driving up costs artificially for third parties like insurance industries.
Pam Dassenko
San Luis Obispo, Calif.
Sept. 23, 2007
The writer is a dentist.
To the Editor:
Paul Krugman’s mention of the scare tactics of health care reform opponents should have included the demonization of universal health care by the news media among his fears (“Health Care Hopes,” column, Sept. 21).
Despite polls suggesting a high popularity for such a system, the news media regurgitate myths and fail to explain the proposals of the health care debate. Single-payer health care is frequently described as “government run” or “socialized medicine,” even though the Canadian, French and German systems involve private doctors, hospitals and other caregivers who merely get paid by the government. Even Senator Hillary Rodham Clinton’s tempered proposal that would involve a private-government partnership did not escape inaccurate accusations.
Until the mainstream media stop distorting reality on behalf of the industry, health care reform will remain at the fringe of political viability, and it will be dead on arrival for the foreseeable future.
Spyros Andreopoulos
Stanford, Calif., Sept. 21, 2007
The writer is director emeritus, Office of Communication and Public Affairs, Stanford University Medical Center.
To the Editor:
Could a Democratic candidate’s determination to deliver on his or her health care promise to voters be undermined by large contributions from companies in the insurance and pharmaceutical industries? And why does it take so much political courage to give the American people what they want? Is there a correlation here?
Barbara H. Peters
Richmond, Va., Sept. 21, 2007