A Modest Proposal

Democrats and Republicans seem rightly to agree that the top priority for health care reform is cost reduction. They disagree primarily over universal coverage. The nature and extent of the latter depend largely on the magnitude of the former. So, Mr. President, why not accept Republican incrementalism for now and force them to put up or shut up by concentrating, first, exclusively on cost containment--if successful, you become a hero, able to advocate more convincingly for the rest of your agenda; if unsuccessful, the rest of your agenda is moot, as it should be.

Abracadabra!

Speaker Pilosi boasted that the Democrats' version of health care reform eliminates a half-trillion dollars of waste, fraud, and abuse. If only saying it could make it so!

Off with their heads! (?)

Congress was in a snit over a Blue Cross subsidiary that announced a 39% rate hike. Rather than focusing (like a laser!) on the magnitude of the increase out of context, the irate regulators should have been more concerned about the company's medical loss ratio, the percentage of each premium dollar spent on paying claims (as opposed to administrative expenses and profit), in order to ensure some reasonable relationship between premium revenues and actuarial risks.

Unintended Consequences?

Central to the Republicans' counterproposal for health care cost-containment is tort reform--making malpractice suits more difficult to initiate and limiting punitive-damages awards. I agree that in our litigious society tort reform is needed, but who, besides the physicians, would benefit economically? In places where tort reform has been successfully implemented (California, Texas), have the physicians reduced their fees to reflect their reduced costs or simply used the savings from lower malpractice insurance premiums to augment their own incomes?

Mr. Fix-it

If a political candidate promises comprehensive solutions to any complex problem, vote for the other guy!

If a political candidate promises that he will pay for his programs by wringing the waste, fraud, and abuse from the system, vote for the other guy!

The president's marathon Health Care Reform Summit agreed in rare bipartisan fashion on the urgent need for cost-containment; but throughout the filibustering and puffery, I heard no mention whatsoever, from either side, of the single most impactful factor--physician practice behavior.

Unconstitutional?

If the United States Constitution is the definitive blueprint for democracy, how can it be, after more than 200 years, that preeminent American jurists still so often disagree on what it says?

Agitators Apply Here

I am hopeful that the Tea Party and other radicals like them from both extremes of the political spectrum may help to energize the electorate and provide the impetus and opportunity for calmer, more thoughtful activists to revivify our moribund democracy.

Bellicose Nation

War on Poverty...War on Illiteracy...War on Hunger...War on Drugs...War on Terrorism...Do you suppose such martial metaphors are as commonplace in Luxembourg or Lichtenstein?

"Dedicated to..."

The Olympian was killed during a practice run. His teammates elected to remain and compete "in his honor." What does that mean? How does it assuage the loss?

Single Payor No Panacea

The physician-activist advocated passionately for a single-payor system, citing the discomfiting reality of Americans dying for lack of medical care. But she neglected to mention that many more Americans die because of their medical care. Credible studies report 225,000 preventable iatrogenic deaths (deaths directly attributable to treatment) annually from misdiagnoses, unnecessary surgeries, hospital-acquired infections, medication errors, adverse drug reactions, et al--making medical care the third-ranking cause of death in the United States, ahead of highway accidents, breast cancer, or AIDS. I, too, espouse the single-payor concept, but unless the scourge of Iatrogenic Disease is aggressively addressed, no amount of "reform" is going to cure what ails us.

To the Editor

Typical of much mindless partisan rhetoric, generating more heat than light, today's Voice of the People contributor insists "We don't want what Obama's selling." Firstly, he means "I," not "We"--this naysayer certainly does not speak for me! Secondly, what is it, exactly, that he does not want? Does he not want health care made available to the 40 million Americans who currently have no insurance coverage and often go without? Does he not want to reduce skyrocketing medical costs and make health care more affordable for all Americans, so no one is driven into bankruptcy because of unexpected illness, and so American employers can compete on a level playing field in the global marketplace? Does he not want the degraded American public education system to once again excel among industrialized nations? Does he not want gay Americans to be regarded as equal and dignified human beings? Does he not want rational regulation of America's financial institutions to forestall a cataclysmic economic collapse? Does he not want to restore America's reputation as a nation of Laws that once was the envy of the civilized world?
The writer employs distraction as a debating technique, by criticizing "bobblehead" Biden's and "pop-up" Pelosi's behavior at the State of the Union address; yes, their antics were annoying, but totally irrelevant to President Obama's agenda or the letter writer's critique. I remind him that trying to be clever is like trying to look beautiful--a failed attempt can render one less attractive.

Pots and Kettles

Equally blameworthy--Republicans who uniformly and mindlessly oppose the president's initiatives, and Democrats who uniformly and mindlessly endorse them.