Concerning: In Cuts to Health Programs, Experts See Difficult Task in Protecting Patients by Robert Pear

Letters to the Editor

The New York Times

letters@nytimes.com

September 23^rd, 2011

Concerning: In Cuts to Health Programs, Experts See Difficult Task in Protecting Patients by Robert Pear

Dear Editor,

A few days ago in his article, Robert Pear reported that if cuts to Medicare and Medicaid are made there is a very substantial risk that beneficiaries access and level of healthcare will be effected. As a 4^th year public health major at the University of California-Berkeley I believe with the current state of the federal budget and with ever rising healthcare costs, the costs of Medicare and Medicaid must be addressed but in a way that beneficiaries will retain the level of medical coverage they need and deserve. If cuts are made, there needs to be another step in health reform, putting some kind of law in place that would force doctors to take a certain number of new Medicare and Medicaid patients per year. Even though the political and administrative feasibility of this might seem daunting, with cuts there cannot be a declining level of coverage.

Sincerely,

Erin Felton

2530 Dwight Way #7

Berkeley, CA 94704

310-795-2154

erin.felton09@gmail.com

RE: Illinois Halts Inquiries of Nonprofit Hospitals

http://prescriptions.blogs.nytimes.com/2011/09/26/illinois-halts-inquiries-of-nonprofit-hospitals/

Letters to the Editor

The New York Times

letters@nytimes.com

September 26, 2011

This letter is a response to the article “Illinois Halts Inquiries of Nonprofit Hospitals” authored by Bruce Jaspen.

Unemployment has surged the state of Illinois in recent years, leaving 1.91 million residents of Illinois uninsured. The collection of property taxes must be combined with an extensive reform on behalf of health care, insurance and the taxation system.

Furthermore while the tax revenues are essential to the maintenance and improvement of the state’s infrastructure, the property tax exemption should remain until the years 2014, when mandatory health insurance for all is expected to take effect.

In the future recommendations, there must be a distinction among the uninsured and those who receive charity. High percentages of uninsured in Illinois and in the United States should be considered as a defunct in institutional structure rather than a few outliers in a scatter plot.

Sincerely,

Kajal Shahali

Peace and Conflict Studies Major and Public Policy Minor

University of California, Berkeley

Email: kjlshahali@berkeley.edu

How One Small Group Sets Doctors’ Pay By PAULINE W. CHEN, M.D.

The crux of Dr. Chen’s article comes down to this problem: there aren’t enough primary care physicians in America, because it is more lucrative to go into specialty care. She attributes this gap in incomes between specialty and GP doctors to the biased governing body (RUC) that sets the prices of 10,000+ procedures in Medicare (and by extension to the prices of almost all medical care). I completely agree with her that the RUC voting members should no longer vote by secret ballot. The city council in the 5,000-person town I live in votes by open ballot, and they only oversee a few million dollars per year. RUC oversees the distribution of $44 billion per year, so they should be held to the highest standards of transparency and accountability.

One issue that Dr. Chen does not discuss is the importance of health care reform. Assuming it does not get repealed before it takes affect in 2014, health care reform will allow millions of currently uninsured and underinsured people to start getting regular care. If we think we’re in a primary care provider shortage now, how about in three years! The government should subsidize medical school tuition so that young doctors can concentrate on treating patients and improving American health, rather than on meeting their next loan payment. Kansas, which has a serious problem with attracting doctors to its rural regions, recently instituted a medical school tuition subsidy, and I’m eager to see how it progresses. Even if RUC keeps its current payment system in the future, where specialist make more than primary care physicians, medical school graduates who care about public health and preventative care for their patients will be able and willing to take a smaller paycheck and stay in primary care if they don’t have $300,000 in debt on their backs.

RE: How One Small Group Sets Doctors' Pay

http://well.blogs.nytimes.com/2011/09/22/how-one-small-group-sets-doctors-pay/?ref=health

Letters to the Editor

New York Times

letters@nytimes.com

September 24, 2011

Dear Editor,

On Thursday (9/22), the article by Dr. Pauline W. Chen entitled “How One Small Group Sets Doctors’ Pay,” examined the discrepancies that continue to define the lifetime earnings of physicians practicing primary care and specialists. As suggested by the lack of transparency and regulation of the RUC, the way in which our healthcare system is structured continues to pay primary care physicians far less than other specialists. I believe that this highlights a controversial issue that must be addressed.

As a public health undergraduate pursuing a career in healthcare, it is disconcerting to know that there is a contradiction in our nation’s goal of keeping Americans healthy and safe. While we emphasize the importance of preventative medicine, which primary care physicians are essential to, we continue to pay them much less than those who specialize in areas whose patients are often already sick and in need of medications, procedures, and prescriptions. In order to successfully address this paradoxical assertion that our nation continues to stand by, I believe that the RUC must be able to accommodate members of the primary care sector more justly so as to ensure that the these doctors are paid adequately for the necessary services they provide in maintaining the well-being of our nation. While there are many factors that contribute to the primary care crisis, management and re-organization of the RUC seems like a practical start to addressing the issue. If we are to believe that preventative medicine is imperative to our nation’s healthcare system, my hope is that we can progress gradually first by recognizing the individuals who dedicate their lives to a profession that makes such goals practical to begin with.

Best regards,

Cheston Wong

Berkeley, Calif., September 24, 2011

RE: Fresno Needle Exchange Proudly Flouts Law

http://www.latimes.com/news/local/la-me-fresno-needles-20110920,0,3940227.story?page=1&utm_medium=feed&track=rss&utm_campaign=Feed%3A%20latimes%2Fnews%2Flocal%20%28L.A.%20Times%20-%20California%20%7C%20Local%20News%29&utm_source=feedburner

Letters to the Editor
LA times
September 19, 2011
letters@latimes.com

To the Editor,

The "Fresno Needle Exchange" article presents an alternative way of alleviating the heroin issue. It takes a step away from the traditional "don't do it" mentality and turns to a more modern approach that promotes safety and disease prevention among the heroin population.

Perhaps it was fate that the proposal to legalize the needle exchange was overturned. Legalization comes with publicity, and publicity comes with judgment, which may deter regular clients from going to the legal clinic to avoid the unyielding eyes of the general public. In a world where differing from the norm attracts unkind stares, I cannot even begin to imagine the discrimination a heroin addict may have to face every day. Increased funding for rehabilitation facilities, which is legal, can be the next step in the fight against heroin. Treatment should be made more accessible and affordable for people that truly want to turn their life around. They just need the opportunity.

Christina Huynh
UC Berkeley
chuynh11@gmail.com

RE: Young Adults Make Gains in Health Insurance Coverage

http://www.latimes.com/news/politics/la-pn-healthcare-young-adults,0,419054.story

The LA Times

September 22, 2011

Dear Editor:

Yesterday, you featured Noem Levey's article “Coverage rises as young adults take advantage of Obama health law.” This is timely with recent evaluations of Obama’s health care policy reform by Republican presidential candidates.

As a student soon-to-be graduating and entering a problematic job market, I speak for the other one-million young adults that extended their health coverage when I express my gratitude for the 2010 health law. Young adults are more likely to go without health insurance than any other age group (27.2% of the young adult population is uninsured). With Obama’s policy amends, my believed “young and invincible” generation has gained access to insurance so often forgone, instead of gambling the incurrence of medical bills.

While universal coverage seems to be a far off reality, our nation needs to continue to make these small steps towards greater health outcomes and less disparity in both the private and public sector. For example, in the public sector, by easing eligibility requirements for Medicaid, more of our nation’s uninsured could reap the benefits of health insurance. This would lead to increased national productivity, increased access to medical services, and more recommended preventative care to lessen avoidable hospitalization—all beneficial and potentially stimulating for our economy.

I do understand that Republicans are targeting this effort, claiming that our nation’s young adults are not the population at highest risk. They argue that insurance should first be extended to help working poor families, the unemployed and ineligible. But, that being said, we have to start somewhere. Why not here?

Best,

Shannon Hamilton

[Shannon.hamilton@berkeley.edu]

(Character count limit: 1400)

Re: Officials opposed to U.S. health-care law seeking interstate compact

Re: Officials opposed to U.S. health-care law seeking interstate compact

http://www.washingtonpost.com/national/health-science/officials-opposed-to-us-health-care-law-seeking-interstate-compact/2011/09/16/gIQAenaWbK_story.html

Letter to the Editor

The Washington Post

letters@washpost.com

September 19, 2011

Dear Editor:

I feel that the proposed compact highlighted in “Officials opposed to U.S. health-care law seeking interstate compact” (Sept. 17) is not the solution to our nation’s health care problems. A lot of issues could potentially arise from this proposition, but my main concern is that this compact does little to address the financial woes of the U.S. health care system as pointed out by Anne Dunkelberg. Even though the U.S. spends the most money of any nation on health care, underfunding in our health care system continues to be a problem regardless of where the power lies. Instead of spending resources and time engaging in campaigns that have sparse support, I urge government officials to direct their efforts to a bigger issue that many would like to eliminate: high health care costs. In particular, some steps I believe our government can take to lower costs are to establish and enforce regulations that prevent medical fraud and to offer incentives for health care providers who promote preventative care and eliminate unnecessary interventions. We can even look abroad to countries such as Switzerland and Germany for further cost-effective ideas for a health care system.

Sincerely,

Yangdi Chen

Berkeley, CA, Sept. 19, 2011